Measuring biomechanics in real time at multiple eye tissue locations.

Abstract

Certain aspects of this disclosure provide a system (10) and a method (800) for measuring biomechanics in real time at multiple ocular tissue locations. In certain embodiments, the method (800) may be performed by a computer (30) communicating with an optical coherence tomography (OCT) device (15, 315). The method includes receiving an index of a stimulus applied to the ocular tissue (346) of a patient (42). The method also includes instructing the OCT device (15, 315) to emit multiple beams (344, 560, 660) substantially simultaneously at multiple measurement locations (772) on the ocular tissue (346) in response to the received index. The method (800) also includes receiving OCT data from the OCT device (15, 315) for each of the multiple measurement locations (772). The method (800) also includes measuring the tissue response to the stimulus at the multiple measurement locations based on the OCT data.

Description

[[Technical Field]]

[0001] Cross-Reference to Related Applications This application claims priority to and incorporates by reference in its entirety the specification of U.S. Provisional Patent Application No. 63 / 579,406, filed on August 29, 2023. [[Background Art]]

[0002] Tissue biomechanics, such as corneal biomechanics, can play an important role in the understanding, diagnosis and treatment of eye diseases such as glaucoma, keratoconus and ectasia. However, the ability to measure such biomechanics is often limited by hardware constraints. For example, optical coherence tomography (OCT) devices are often not fast enough to capture useful measurements. [[Summary of the Invention]] [[Problem to be Solved by the Invention]]

[0003] The present disclosure relates to diagnostic systems and methods, and in particular to systems and methods for real-time measurement of biomechanics at a plurality of ocular tissue positions. [[Means for Solving the Problem]]

[0004] In certain specific embodiments, one general aspect includes a system for real-time measurement of biomechanics at a plurality of ocular tissue positions. The system includes an optical coherence tomography (OCT) device, and a computer communicatively coupled to the OCT device. The computer is operable to receive an indication of a stimulus applied to a patient's ocular tissue, and instruct the OCT device to emit a plurality of beams at a plurality of measurement positions on the ocular tissue substantially simultaneously in response to the received indication. The computer is also operable to receive OCT data for each of the plurality of measurement positions from the OCT device. The computer is also operable to measure tissue responses to the stimulus at the plurality of measurement positions based on the OCT data.

[0005] In a particular embodiment, another general aspect includes a method for measuring biomechanics in real time at multiple ocular tissue locations. The method may be performed by a computer communicating with an optical coherence tomography (OCT) device. The method includes receiving an index of a stimulus applied to the patient's ocular tissue. The method also includes instructing the OCT device to emit multiple beams substantially simultaneously at multiple measurement locations on the ocular tissue, in response to the received index. The method also includes receiving OCT data from the OCT device for each of the multiple measurement locations. The method also includes measuring the tissue response to the stimulus at the multiple measurement locations based on the OCT data.

[0006] To allow for a more detailed understanding of the features of the Disclosure cited above, a more specific description of the Disclosure, which has been briefly summarized above, can be obtained by referring to embodiments, some of which are shown in the accompanying drawings. However, it should be noted that the accompanying drawings are merely illustrative embodiments and should not be considered to limit their scope, and other similarly effective embodiments may be recognized. [Brief explanation of the drawing]

[0007] [Figure 1A] Figure 1A shows the configuration of one embodiment of an ophthalmic diagnostic system according to a particular embodiment of the present disclosure. [Figure 1B] Figure 1B shows the configuration of another embodiment of an ophthalmic diagnostic system according to a particular embodiment of the present disclosure. [Figure 2] Figure 2 is a block diagram of various components of the ophthalmic diagnostic system shown in Figures 1A and 1B, according to a particular embodiment of the present disclosure. [Figure 3] Figure 3 shows an embodiment of an ophthalmic diagnostic system according to a particular embodiment of the present disclosure. [Figure 4] Figure 4 shows an example of an optical coherence tomography (OCT) engine capable of generating multiple imaging light beams, according to a particular embodiment of the present disclosure. [Figure 5]Figure 5 shows another embodiment of an OCT engine capable of generating multiple imaging light beams, according to a particular embodiment of the present disclosure. [Figure 6] Figure 6 shows another embodiment of an OCT engine capable of generating multiple imaging light beams, according to a particular embodiment of the present disclosure. [Figure 7A-C] Figures 7A-7C show measurement patterns for an example applied to the eye according to one embodiment of the present disclosure. [Figure 8] Figure 8 shows one example of a process for measuring corneal biodynamics in real time at multiple locations, according to a particular embodiment of the present disclosure.

[0008] For ease of understanding, the same reference numerals are used to indicate identical elements common to the drawings, where possible. It is assumed that elements and features of one embodiment may be usefully incorporated into other embodiments without further detail. [Modes for carrying out the invention]

[0009] For the purpose of facilitating understanding of the principles of this disclosure, implementations shown in the drawings are referred to and described using specific language. However, it should be understood that this does not limit the scope of this disclosure in any way. Any substitutions and further modifications to the systems, apparatus, devices, and methods described, as well as any further applications of the principles of this disclosure, are fully considered in a manner that would ordinarily occur to a person skilled in the art, in particular, that features, components, and / or steps described in relation to one implementation may be combined with features, components, and / or steps described in relation to other embeddings of this disclosure. For simplification, in some cases, the same reference numeral is used throughout the drawings to refer to the same or similar parts.

[0010] Ocular biomechanics, including corneal biomechanics such as corneal stiffness, can play a crucial role in understanding, diagnosing, and treating diseases such as glaucoma, keratoconus, and corneal ectasia. Detailed clinical evaluation of corneal biomechanics has the potential to revolutionize the ophthalmology industry, for example, by enabling personalized LASIK (laser-assisted corneal reshaping) and cataract surgery. Evaluation and understanding of corneal biomechanics can be applied in corneal surgery to identify patient suitability and improve the safety and effectiveness of surgical procedures. For example, corneal ectasia is an extremely rare but serious complication of refractive surgery occurring in 0.04–0.6% of cases. Measuring the biomechanical properties of the cornea can facilitate preoperative screening of candidates for refractive surgery to minimize the risk of postoperative corneal ectasia. For example, in cataract surgery, postoperative induced astigmatism (SIA), ranging from 0–1.5D, can be an unexpectedly significant cause of refractive error. Accurate measurement of corneal biomechanics can enable better prediction of patient-specific SIA for cataract surgery, thereby improving surgical outcomes.

[0011] One method for measuring compressive stiffness is, for example, Young's modulus. Calculating Young's modulus typically involves measuring the propagation velocity of shear waves across the corneal surface in response to a stimulus. Theoretically, the propagation velocity can be measured using data generated by an optical coherence tomography (OCT) device. However, in practice, shear waves can propagate at speeds of, for example, tens of meters per second. Generally, it takes only a few milliseconds for a shear wave to propagate across the entire cornea. Since OCT devices often operate at speeds below 100 kilohertz, and OCT-based methods involve scanning a laser beam, measuring the propagation velocity of shear waves using OCT-based methods is difficult. While it might be possible to circumvent some of these technical difficulties by repeatedly applying stimuli to the same location and then measuring the shear wave propagation velocity at different locations and times, such a process is time-consuming and generally unsuitable for in vivo applications.

[0012] This disclosure describes embodiments of an OCT-based method for measuring biomechanics in real time at multiple locations on a patient's eye. In various embodiments, for example, a stimulus may be applied to the patient's cornea. A computer can then instruct or cause an OCT device to emit multiple beams simultaneously at multiple locations on the cornea. In various embodiments, the multiple beams result in OCT data received for each of the multiple locations in response to a single stimulus. Advantageously, in certain embodiments, the OCT data can be used to measure the corneal response to a single stimulus at multiple locations, thereby significantly reducing measurement time. For example, shear wave velocity can be calculated more efficiently and reliably based on OCT data acquired simultaneously from multiple locations. Furthermore, in various embodiments, shear wave velocity can be measured more easily in multiple directions. Specific embodiments will be described in more detail with reference to the drawings.

[0013] For illustrative purposes, this disclosure describes various embodiments relating to the measurement of corneal biomechanics. However, it should be recognized that similar principles are also applicable to measuring the biomechanics of other parts and / or other tissues of the eye.

[0014] Figures 1A, 1B, and 2 show one embodiment of the ophthalmic diagnostic system 10 according to a particular embodiment. The ophthalmic diagnostic system 10 may be used for different types of diagnostic and therapeutic procedures. For example, the ophthalmic diagnostic system 10 may be used for the diagnosis or treatment of glaucoma, keratoconus, and / or diastema. In addition, or alternatively, the ophthalmic diagnostic system 10 may be used to provide data for personalizing LASIK or cataract surgery.

[0015] FIG. 1A shows a configuration 100A of an ophthalmic diagnosis system 10. In particular, FIG. 1A shows the head 6 of a patient 42 lying on a bed 8. In the illustrated embodiment, the ophthalmic diagnosis system 10 includes a camera 38 and a portion 39 through which a plurality of imaging light beams can exit the ophthalmic diagnosis system 10 and travel through a region 41 toward the patient 42.

[0016] FIG. 1B shows a configuration 100B of the ophthalmic diagnosis system 10. In the configuration 100B, the ophthalmic diagnosis system 10 is configured as a desktop imaging system in which the patient 42 sits on a chair 9.

[0017] Referring to FIG. 2, the ophthalmic diagnosis system 10 includes an OCT device 15, a camera 38, and a control computer 30 coupled as illustrated. The OCT device 15 includes controllable components such as an OCT engine 12, a beam scanner 16, one or more optical elements 17, and / or a focusing objective lens 18 coupled as illustrated. The computer 30 includes a logic 36 coupled as illustrated, a memory 32 (storing a computer program 34), and a display 37. For ease of description, the following xyz coordinate system is used: that is, the z direction is defined by the propagation direction of the imaging light beam, and the xy plane is perpendicular to the propagation direction. Other suitable xyz coordinate systems may also be used.

[0018] Referring particularly to the OCT device 15, the OCT engine 12 generates and emits a plurality of imaging light beams guided to the tissue of the eye 22 of the patient 42. For example, the imaging light beams may be guided to different locations on the corneal surface of the eye 22. As will be described in more detail with reference to FIGS. 3 to 6, 7A to 7C, and 8, the OCT engine 12 can generate and emit imaging light beams substantially simultaneously (that is, simultaneously).

[0019] Based on its configuration and positioning, the beam scanner 16 variably guides an imaging light beam to one or more optical elements 17. For example, the beam scanner 16 may variably guide the imaging light beam by directing the imaging light beam in a lateral direction and / or a longitudinal direction. The lateral direction refers to a direction perpendicular to the beam propagation direction, i.e., the x and y directions. The beam scanner 16 may direct the imaging light beam in the lateral direction in any suitable manner. For example, the beam scanner 16 may include a pair of galvanometer-operated scanner mirrors that can be tilted relative to axes orthogonal to each other. As another example, the beam scanner 16 may include an electro-optic crystal capable of electro-optically guiding the imaging light beam. In some embodiments, the beam scanner 16 can simultaneously condition the imaging light beam emitted by the OCT engine 12.

[0020] The longitudinal direction refers to a direction parallel to beam propagation, i.e., the z direction. The beam scanner 16 may direct the imaging light beam in the longitudinal direction in any suitable manner. For example, the beam scanner 16 may include a longitudinally adjustable lens, a variable power lens, or a deformable mirror capable of controlling the z-position of the beam focal point. Components of the beam scanner 16 may be arranged in any suitable manner along an appropriate beam path, for example, in the same or different modular units.

[0021] One or more optical elements 17 guide the imaging light beam toward a focusing objective lens 18. The optical element 17 may act (e.g., transmit, reflect, refract, diffract, collimate, condition, shape, focus, modulate, and / or otherwise act) on the imaging light beam. Examples of optical elements include lenses, prisms, mirrors, diffractive optical elements (DOE), holographic optical elements (HOE), and spatial light modulators (SLM). In one specific embodiment, the optical element 17 is a mirror or a dichroic mirror. The focusing objective lens 18 focuses the imaging light beam toward a portion of an eye 22, such as the corneal surface of the eye. In an embodiment, the focusing objective lens 18 is an objective lens, for example, an fθ objective lens.

[0022] The OCT engine 12 receives the backscattered imaging light beam from the eye 22 along the opposite direction of the imaging light beam. The OCT engine 12 can be configured to generate one or more images to provide practical feedback for storage, as will be described in detail below. For example, in various embodiments, the OCT engine 12 is configured to perform interferometric analysis of the back imaging light beam to provide OCT data representing position-dependent structural characteristics of the eye 22, such as the structural characteristics of the cornea. For example, the OCT engine 12 can be configured to provide OCT data representing an image of the cornea at or near the focal positions x, y, z, and to provide OCT data representing the position-dependent optical density n(x,y,z) and position-dependent mass density p(x,y,z) of the cornea.

[0023] While a specific embodiment of the OCT device 15 has been described above, it should be recognized that in various embodiments, the OCT device 15 can be configured to perform different types of OCT scans. In one embodiment, in several embodiments, the OCT device 15 can be configured to perform an M scan. In another embodiment, the OCT device 15 can be configured to perform a B scan. In yet another embodiment, the OCT device 15 can be configured to perform an MB scan. In yet another embodiment, the OCT device 15 can be configured to perform a BM scan. Other embodiments will become apparent to those skilled in the art after a detailed examination of this disclosure.

[0024] The camera 38 can sequentially capture one or more images of the patient 42. For example, the camera 38 can focus on the eye 22. Embodiments of the camera 38 include video, interferometer, thermal imaging, ultrasound, OCT, and target tracking cameras. The camera 38 sends image data representing the recorded images of the eye 22 to the computer 30. In some embodiments, the camera 38 may be an integral part of the OCT device 15 rather than being separate, as shown in Figure 2.

[0025] The computer 30 controls the components of the ophthalmic diagnostic system 10 according to the computer program 34. For example, the computer 30 controls the components (e.g., the OCT engine 12, the beam scanner 16, the optical elements 17, and / or the focusing objective lens 18) to focus the imaging light beam of the OCT engine 12 to a desired measurement position on the eye 22, such as a desired measurement position on the corneal surface of the eye. The memory 32 stores information used by the computer 30. For example, the memory 32 may store images of the eye 22, OCT data, and / or other appropriate information, and the computer 30 may access information from the memory 32. In various embodiments, the computer program 34 and its functions, such as focusing the imaging light beam, can be directed by a user, such as a medical professional.

[0026] In a particular embodiment, the computer 30 can measure the corneal biomechanics of the eye 22 in real time at multiple locations. In a particular embodiment, the computer 30 monitors indicators of stimuli applied to the patient's cornea. When the computer 30 detects a stimulus or is notified of such a stimulus (e.g., by the user), the computer 30 can instruct or cause the OCT device 15 to emit multiple imaging light beams to multiple different locations on the patient's cornea. The computer 30 can then receive OCT data resulting from the imaging light beams from the OCT device 15. The OCT data can be used by the computer 30 to measure the corneal response to the stimulus at each of the multiple different locations, depending on the detected stimulus. The computer 30 can record the OCT data and / or data relating to the measured corneal response in memory 32 or other storage.

[0027] Figure 3 shows one embodiment of the ophthalmic diagnostic system 310. Generally, the ophthalmic diagnostic system 310 may include any of the components and functions described in relation to the ophthalmic diagnostic system 10 in Figures 1A-B and 12. Similarly, the ophthalmic diagnostic system 10 may include any of the components and functions described in relation to the ophthalmic diagnostic system 310. Therefore, for the sake of clarity, similar components of the ophthalmic diagnostic system 10 and the ophthalmic diagnostic system 310 may be referred to as interchangeable on a regular basis. For simplicity, the explanatory diagram in Figure 3 focuses on the OCT device 315, the camera 338, and the stimulator 352 of the embodiment.

[0028] In the illustrated embodiment, the OCT apparatus 315 includes an OCT engine 312, a beam scanner 316, one or more optical elements 317, a focusing objective lens 318, and lights 348(1) and 348(2). Generally, the OCT engine 312, beam scanner 316, one or more optical elements 317, and focusing objective lens 318 can operate as described for the OCT engine 12, beam scanner 16, one or more optical elements 17, and / or focusing objective lens 18 in Figure 2, respectively.

[0029] Similar to the OCT engine 12 in Figure 2, the OCT engine 312 generates and emits multiple imaging light beams guided to the surface of the cornea 346 of the eye 322, and can then receive a return imaging light beam backscattered from the eye 322 along the opposite direction of the imaging light beams. For illustrative purposes, the OCT engine 312 is shown generating and emitting three imaging light beams, namely imaging light beams 344(1), 344(2), and 344(2) (collectively referred to as imaging light beam 344). However, it should be noted that the amount of imaging light beam 344 can be configured to suit a given implementation.

[0030] In the embodiment shown in Figure 3, the beam scanner 316 variably guides the imaging light beam 344 to a specific location on one or more optical elements 317 based on its configuration and / or positioning. The one or more optical elements 317 guide the imaging light beam 344 to a specific location on the focusing objective lens 318 based on or in accordance with the specific location to which the imaging light beam 344 is guided by the beam scanner 316. For example, different beams may be directed to different locations on the focusing objective lens 318 due to the position and / or location variation characteristics of the one or more optical elements 317. The focusing objective lens 318 can focus the imaging light beam 344 to a plurality of desired measurement locations on the cornea 346. In the embodiment shown in Figure 3, the one or more optical elements 317 are shown as dichroic mirrors, and the focusing objective lens 318 is shown as an objective lens.

[0031] In some embodiments, camera 338 may be an iris camera that can be focused on or fixed to eye 322 and provides a series of images of eye 322 to computer 30. In various embodiments, lights 348(1) and 348(2) can improve the image acquisition quality by camera 338. For illustrative purposes, lights 348(1) and 348(2) are shown as light-emitting diodes (LEDs) that direct light toward eye 322. Camera 338 can operate as described in relation to camera 38 in Figures 1A-B and 2. Those skilled in the art will recognize that the components shown in Figure 3 can exist in any suitable number or configuration. For example, it should be recognized that the two lights shown in Figure 3, i.e., lights 348(1) and 348(2), can be modified in quantity, type, and / or configuration to suit a given implementation.

[0032] The stimulator 352 can be any suitable device for applying external stimuli to the cornea 346. For example, the stimulator 352 can induce corneal displacement by applying air pulses. In another embodiment, the stimulator 352 can induce corneal displacement by applying ultrasound. Other embodiments of stimulation will become apparent to those skilled in the art after a detailed examination of this disclosure.

[0033] In various embodiments, the computer 30 in Figure 2 monitors an index of stimulation applied to the cornea 346 by the stimulator 352. When the computer 30 detects stimulation applied by the stimulator 352, or is notified of stimulation (for example, by the user), the computer 30 can command or cause the OCT device 315 to emit multiple imaging light beams 344 substantially simultaneously (i.e., at the same time) to multiple different locations on the cornea 346. The computer 30 can then receive OCT data resulting from the imaging light beams 344 from the OCT device 315. The OCT data can be used by the computer 30 to measure the corneal response to the stimulation at each of the multiple different locations, depending on the detected stimulation. The computer 30 can record the OCT data and / or data relating to the measured corneal response in memory 32 or other storage.

[0034] Figure 4 shows one embodiment of an OCT engine 412 capable of generating multiple imaging light beams. In various embodiments, the OCT engine 412 can function as the OCT engine 12 in Figure 2 and / or as the OCT engine 312 in Figure 3. In the illustrated embodiment, the OCT engine 412 includes a beam source 454, a beam splitter 458, and optical elements 462(1) and 462(2).

[0035] In the illustrated embodiment, the beam source 454 generates a source beam 456 in any suitable manner. The beam splitter 458 splits the source beam 456 into a first beam 460(1) to optical element 462(1) and a second beam 460(2) to optical element 462(2). The beam splitter 458 may optionally be any suitable device for splitting an optical beam, such as a polarizing beam splitter.

[0036] Optical elements 462(1) and 462(2) direct beams 460(1) and 460(2) toward the beam scanner 316, respectively, so that beams 460(1) and 460(2) are multiple imaging light beams generated by the OCT engine 412. Optical elements 462(1) and 462(2) can act on beams 460(1) and 460(2) respectively (e.g., transmit, reflect, refraction, diffraction, sighting, adjustment, shaping, focusing, modulation, and / or act separately). Examples of optical elements 462(1) and 462(2) include lenses, prisms, mirrors, diffractive optical elements (DOEs), holographic optical elements (HOEs), and spatial light modulators (SLMs). In the embodiment shown in Figure 4, optical elements 462(1) and 462(2) are mirrors. Beams 460(1) and 460(2) can be guided to the cornea, such as the cornea 346 in Figure 3, via the beam scanner 316, as generally explained with respect to Figures 1A-B, 2, and 3.

[0037] Figure 5 shows one embodiment of an OCT engine 512 capable of generating multiple imaging light beams. In various embodiments, the OCT engine 512 can function as the OCT engine 12 in Figure 2 and / or as the OCT engine 312 in Figure 3. In the illustrated embodiment, the OCT engine 512 includes a beam source 554, a beam splitter 558, and optical elements 564(1), 564(2), 564(3), and 564(4) (collectively referred to as optical element 564).

[0038] In the illustrated embodiment, the beam source 554 generates a source beam 556 in any suitable manner. The beam splitter 558 splits the source beam 556 into a first beam 560(1) directed towards optical element 564(1), a second beam 560(2) directed towards optical element 564(2), a third beam 560(3) directed towards optical element 564(3), and a fourth beam 560(4) directed towards optical element 564(4) (collectively known as beam 560). The beam splitter 558 can be any suitable device for splitting an optical beam. In the embodiment of Figure 5, the beam splitter 558 is a 1 × N fiber beam splitter, where N is equal to 4 in the illustrated embodiment. However, it should be recognized that the beam splitter 558 can split the source beam 556 into beams of different quantities according to the requirements of a given implementation configuration.

[0039] The optical element 564 directs the beam 560 towards the beam scanner 316 so that the beam 560 is a plurality of imaging light beams generated by the OCT engine 512. The optical element 564 can act on the beam 560 (e.g., transmit, reflect, refraction, diffraction, sighting, adjustment, shaping, focusing, modulation, and / or other actions). Examples of optical elements 564 include lenses, prisms, mirrors, diffractive optical elements (DOEs), holographic optical elements (HOEs), and spatial light modulators (SLMs). In the embodiment of Figure 5, the optical element 564 is a collimator. The beam 560 can be guided through the beam scanner 316 to the cornea, such as the cornea 346 in Figure 3, as generally described for Figures 1A-B, 2, and 3.

[0040] Figure 6 shows one embodiment of an OCT engine 612 capable of generating multiple imaging light beams. In various embodiments, the OCT engine 612 can function as the OCT engine 12 in Figure 2 and / or as the OCT engine 312 in Figure 3. In the illustrated embodiment, the OCT engine 612 includes a beam source 654, beam splitters 658(1), 658(2), and 658(3), and optical elements 664(1), 664(2), 664(3), and 664(4) (collectively referred to as optical element 664). It should be noted that the beam splitters 658(1), 658(2), and 658(3) can be configured to split the light beam in any suitable manner.

[0041] In the illustrated embodiment, the beam source 654 generates the source beam 656 in any suitable manner. The beam splitter 658(1) splits the source beam 656 into a first intermediate beam 659(1) directed toward the beam splitter 658(2) and a second intermediate beam 659(2) directed toward the beam splitter 658(3). For clarity, the intermediate beams 659(1) and 659(2) are referred to as "intermediate" because they do not represent the beam output by the OCT engine 612.

[0042] Continuing with the embodiment shown in Figure 6, the beam splitter 658(2) splits the intermediate beam 659(1) into a first output beam 660(1) directed towards optical element 664(1) and a second output beam 660(2) directed towards optical element 664(2). Similarly, the beam splitter 658(3) splits the intermediate beam 659(2) into a third output beam 660(3) directed towards optical element 664(3) and a fourth output beam 660(4) directed towards optical element 664(4). Collectively, the output beams 660(1), 660(2), 660(3), and 660(4) are referred to as output beam 660.

[0043] The optical element 664 directs the output beam 660 towards the beam scanner 316 so that the output beam 660 is a plurality of imaging light beams generated by the OCT engine 612. The optical element 664 can act on the output beam 660 (e.g., transmit, reflect, refraction, diffraction, sighting, adjustment, shaping, focusing, modulation, and / or other actions). Examples of optical elements 564 include lenses, prisms, mirrors, diffractive optical elements (DOEs), holographic optical elements (HOEs), and spatial light modulators (SLMs). In the embodiment of Figure 6, the optical element 664 is a collimator. The output beam 660 can be guided through the beam scanner 316 to the cornea, such as the cornea 346 in Figure 3, as generally described for Figures 1A-B, 2, and 3.

[0044] Figures 7A-7C show measurement patterns for an embodiment applied to the eye. The eye is shown with the cornea 746, conjunctiva 766, and limbus 768. Figure 7A shows measurement pattern 700A. In measurement pattern 700A, a stimulus is applied to a stimulus site 770A on the cornea 746, for example, via the stimulus device 352 in Figure 3. In response to the stimulus, an imaging light beam may be emitted substantially simultaneously (i.e., simultaneously) to the measurement site 772A, and as a result, a corneal response may be measured.

[0045] Figure 7B shows a measurement pattern 700B of one embodiment. In measurement pattern 700B, a stimulus is applied to a stimulation site 770B on the cornea 746, for example, via the stimulation device 352 of Figure 3. In response to the stimulus, an imaging light beam may be emitted to the measurement site 772B almost simultaneously (i.e., at the same time), and as a result, a corneal response may be measured.

[0046] Figure 7C shows a measurement pattern 700C of one embodiment. In measurement pattern 700C, a stimulus is applied to a stimulation position 770C on the cornea 746, for example, via the stimulation device 352 shown in Figure 3. In response to the stimulus, an imaging light beam may be emitted to the measurement position 772C almost simultaneously (i.e., at the same time), and as a result, a corneal response may be measured.

[0047] Figure 8 shows one embodiment of process 800 for measuring corneal biomechanics in real time at multiple corneal locations. In a particular embodiment, process 800 can be implemented by any system capable of processing OCT data. For the sake of simplicity, any number of systems can implement process 800, either entirely or partially, but process 800 will be described in terms of components of the ophthalmic diagnostic system 10 in Figures 1A-B and 2 and the ophthalmic diagnostic system 310 in Figure 3.

[0048] In block 802, the computer 30 monitors indicators of when a stimulus has been applied to the patient's cornea, for example, the cornea 346 in Figure 3. The indicators may include, for example, automatic detection of the application of a stimulus, a user-supplied input indicating that a stimulus has been applied, a synchronization signal generated by the computer, the expiration of a synchronization timer for applying a stimulus, or a combination of the above. In various embodiments, the stimulus indicators may include, or be accompanied by, indicators of the location of the stimulus. The stimulus can be applied, for example, via the stimulator 352 in Figure 3 to stimulus locations such as 770A, 770B, and 770C in Figures 7A, 7B, and 7C, respectively.

[0049] In decision block 804, the computer 30 determines whether it has received an indicator of the stimulus to be applied to the patient's eye. If it has not received an indicator of the stimulus, process 800 returns to block 802 and continues as described above. Otherwise, if it determines in decision block 804 that it has received an indicator of the stimulus, process 800 proceeds to block 806.

[0050] In block 806, the computer 30 commands the OCT device 15 to emit multiple imaging light beams substantially simultaneously (i.e., at the same time) at multiple desired measurement locations on the patient's cornea. In one embodiment, the desired measurement locations may correspond to measurement locations 772A, 772B, or 772C in Figures 7A, 7B, and 7C, respectively. The command to the OCT device 15 causes the OCT device 15 to generate and emit multiple imaging light beams in any of the methods described above with respect to Figures 1A-B and 2-6, and to provide OCT data based on them. In block 808, the computer 30 receives from the OCT device 15 the OCT data generated by the OCT device 15 for each of the multiple measurement locations.

[0051] In block 810, the computer measures the corneal response to stimuli at multiple measurement locations based on OCT data. For example, the computer 30 can measure the propagation velocity of shear waves along or across the patient's cornea based on the measurement location. In a particular embodiment, the computer 30 can quantify tissue stiffness (e.g., Young's modulus) based on the propagation velocity of shear waves. For example, if viscosity is negligible, Young's modulus (E) is given by the propagation velocity of shear waves, or shear wave velocity (S), based on the following equation 1. c This can be related to the equation, where p is the material density and mv is Poisson's ratio. In general, microstructure hardness is proportional to Young's modulus, and a higher Young's modulus corresponds to greater (longitudinal) hardness. E = 2 × p × (1 + mv) × S c formula 1

[0052] In block 812, the computer 30 stores and / or displays OCT data and resulting data from blocks 808 and 810, such as corneal biomechanics. In various embodiments, the OCT data and / or resulting corneal biomechanics can be stored in memory 32 or other storage with respect to the patient. In addition, or alternatively, the OCT data and / or resulting biomechanics can be displayed to the user or operator of the ophthalmic diagnostic system 10.

[0053] In decision block 814, the computer 30 determines whether to collect additional corneal biomechanics in response to further stimulation of the patient's eye. If decision block 814 determines to collect additional corneal biomechanics, process 800 returns to block 802 and proceeds as previously described. Otherwise, process 800 terminates.

[0054] In various embodiments, diagnostic systems such as the diagnostic systems of the embodiments described herein can have various advantages. For example, such diagnostic systems that measure the biomechanical properties of affected or healthy corneas can enable the inclusion of new metrics in treatment planning algorithms to enhance predictability and surgeon confidence. For instance, corneal biomechanics, as described herein, can not only help evaluate therapeutic interventions in comparison to cross-linking but may also help evaluate collagen degradation. Furthermore, in some embodiments, corneal biomechanics are highly correlated with myopia, thereby influencing the success of corneal refractive correction (orthokeratology) (e.g., myopia reduction). High myopia can increase the risk of glaucoma. Therefore, in certain embodiments, corneal biomechanics, such as those described herein, can help predict or identify the risk of myopia and / or glaucoma.

[0055] In addition, or alternatively, in various embodiments, diagnostic systems such as the diagnostic systems of the embodiments described herein can help identify patients at risk of post-LASIK complications. Typically, refractive surgery planning uses population-based averages of corneal biomechanics. Statistically, approximately 1% of LASIK patients experience diastema. In various embodiments, personalized corneal biomechanics, such as those described herein, may improve the ability to predict surgical intervention risks, such as post-LASIK diastema.

[0056] Additionally, or as an alternative, the ability to generate corneal biomechanical measurements and apply them to treatment algorithms can support more accurate estimation, prediction, and / or establishment of cataract outcomes from patient-specific postoperative induced astigmatism (SIA), limbal retraction (LRI) outcomes from patient-specific calculations, treatment decisions for corneal refractive power, orthokeratology outcomes, and treatment and / or diagnosis of dry eye, etc. For example, SIA can range from 0 to 1.5D, which can be an unexpectedly significant source of refractive power. Corneal biomechanics, as described herein, can enable better prediction of patient-specific SIA for cataract surgery and improve the accuracy of LRI.

[0057] The subject matter disclosed above should be considered illustrative, not limiting, and the attached claims are intended to encompass all modifications, improvements, and other embodiments within the true intent and scope of this disclosure. Therefore, to the maximum extent permitted by law, the scope of this disclosure is defined by the broadest permissible interpretation of the following claims and their equivalents, and is not limited or restricted by the foregoing detailed description.

Claims

1. A system for measuring biomechanics in real time at multiple eye tissue locations, Optical coherence tomography (OCT) equipment, A computer that is communicatively connected to the OCT device, The indicators of the stimulation applied to the patient's eye tissue are received. In accordance with the received indicator, the OCT device is instructed to emit multiple beams substantially simultaneously at multiple measurement locations on the eye tissue. The OCT device receives OCT data for each of the multiple measurement positions. Based on the OCT data, the tissue response to the stimulus at the plurality of measurement locations is measured. A computer capable of operating in this manner, A system that includes these features.

2. The system according to claim 1, wherein the OCT device comprises an OCT engine that generates the plurality of beams substantially simultaneously in response to the command.

3. The OCT apparatus further comprises a beam scanner, an optical element, and a focusing objective lens. The beam scanner guides the generated beams to a first set of positions on the optical element. The optical element guides the guided beams toward a second set of positions on the focusing objective lens based on the first set of positions. The focusing objective lens focuses the induced beams onto the plurality of measurement positions on the eye tissue. The system according to claim 2.

4. The system according to claim 3, wherein the optical element is a dichroic mirror.

5. The OCT engine comprises a beam splitter and first and second optical elements. The beam splitter divides the source beam into a first beam to the first optical element and a second beam to the second optical element. The first and second optical elements guide the first and second beams to the beam scanner. The plurality of beams generated by the OCT engine comprises the induced first and second beams. The system according to claim 2.

6. The OCT engine comprises a fiber beam splitter and first and second optical elements. The fiber beam splitter divides the source beam into a first beam to the first optical element and a second beam to the second optical element. The first and second optical elements guide the first and second beams to the beam scanner. The plurality of beams generated by the OCT engine comprises the induced first and second beams. The system according to claim 2.

7. The OCT engine comprises a plurality of beam splitters, including first, second, and third beam splitters, and a plurality of optical elements, including first, second, third, and fourth optical elements. The first beam splitter divides the source beam into a first intermediate beam to the second beam splitter and a second intermediate beam to the third beam splitter. The second beam splitter divides the first intermediate beam into a first output beam to the first optical element and a second output beam to the second optical element. The third beam splitter divides the second intermediate beam into a third output beam to the third optical element and a fourth output beam to the fourth optical element. The first, second, third, and fourth optical elements guide the output beams of the first, second, third, and fourth optical elements to the beam scanner. The plurality of beams generated by the OCT engine comprises the induced first, second, third, and fourth output beams. The system according to claim 2.

8. The system according to claim 1, wherein the computer is operable to record or display data resulting from the measured tissue response.

9. The system according to claim 1, wherein the measurement includes measuring the propagation velocity of shear waves over at least a portion of the ocular tissue based on the OCT data.

10. The system according to claim 9, wherein the measurement includes quantifying the tissue stiffness based on the propagation speed of the shear wave.

11. The system according to claim 1, wherein the ocular tissue comprises the cornea of ​​the patient.

12. A method for measuring biomechanics in real time at multiple ocular tissue locations, wherein a computer communicates with an optical coherence tomography (OCT) device, Receiving indicators of the stimulation applied to the patient's eye tissue, The OCT device is instructed to emit multiple beams substantially simultaneously at multiple measurement locations on the eye tissue in accordance with the received indicators. The OCT device receives OCT data for each of the multiple measurement positions, Based on the OCT data, the tissue response to the stimulus at the plurality of measurement locations is measured, Methods that include...

13. The method according to claim 12, comprising recording or displaying data resulting from the measured tissue response.

14. The method according to claim 12, wherein measuring the tissue response includes measuring the propagation velocity of shear waves over at least a portion of the ocular tissue based on the OCT data.

15. The method according to claim 14, wherein the measurement includes quantifying the tissue stiffness based on the propagation speed of the shear wave.

16. Furthermore, the method according to claim 12, wherein the OCT device generates the plurality of beams substantially simultaneously in response to the command.

17. Furthermore, The generated plurality of beams are guided to a first plurality of positions on an optical element via a beam scanner, The optical element guides the multiple beams guided based on the first multiple positions toward a second multiple positions on the focusing objective lens, The induced beams are focused onto the plurality of measurement positions on the ocular tissue via the focusing objective lens, The method according to claim 16, including the method described in claim 16.

18. Generating the aforementioned multiple beams means The source beam is split into a first beam to the first optical element and a second beam to the second optical element, The first and second beams are guided to a beam scanner via the first and second optical elements, wherein the generated plurality of beams comprises the guided first and second beams. The method according to claim 16, including the method described in claim 16.

19. Generating the aforementioned multiple beams means The source beam is divided into a first intermediate beam and a second intermediate beam, The first intermediate beam is divided into a first output beam to a first optical element and a second output beam to a second optical element, The aforementioned second intermediate beam is divided into a third output beam to a third optical element and a fourth output beam to a fourth optical element, The first, second, third, and fourth output beams are guided to a beam scanner via the first, second, third, and fourth optical elements, wherein the generated plurality of beams comprises the guided first, second, third, and fourth output beams. The method according to claim 16, including the method described in claim 16.

20. A computer program product comprising a non-temporary computer-usable medium having embedded computer-readable program code, wherein the computer-readable program code is Receiving indicators of the stimulation applied to the patient's eye tissue, In response to the received instructions, the optical coherence tomography (OCT) device is instructed to emit multiple beams substantially simultaneously at multiple measurement locations on the eye tissue, The OCT device receives OCT data for each of the multiple measurement positions, Based on the OCT data, the tissue response to the stimulus at the plurality of measurement locations is measured, A computer program product adapted to be executed in a manner that includes implementing methods.

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