Glaucoma Perimeter Adaptive Point Selection

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Solution Overview

Problem

Current perimetry methods for assessing visual field progression in Glaucoma Optic Neurosis are burdensome for examinees, requiring extensive time and frequency, leading to potential delays in timely medical intervention.

Innovation Solution

A perimeter device that selects subsequent measurement points based on pattern deviation probability plots, focusing on areas with lower P values to efficiently assess visual field abnormalities, allowing for more frequent and accurate monitoring with reduced examinee burden.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If perimetry is conducted with many measurement points (54-76 points) to ensure comprehensive visual field assessment, then measurement precision is improved, but examination time increases and burden on examinee increases

Engineering Contradiction:
Improvevisual field assessment accuracyVSAvoidexamination time
Core Design Contradiction:
Measurement precisionVSLoss of time

Solution Approach 1:

The patent segments the visual field assessment into two phases: an initial comprehensive perimetry covering all standard measurement points, followed by a focused re-inspection on only the selected subsequent measurement points showing abnormality. This segmentation allows the full visual field to be assessed initially while subsequent exams focus only on problematic areas, reducing time for follow-up examinations.

Inventive Principle:
Principle #1Segmentation

Solution Approach 2:

The patent extracts and identifies specific subsequent measurement points from the complete set of measurement points by analyzing the first perimetry results. Points showing abnormality (P≤5%) are extracted as subsequent measurement points for focused re-inspection, eliminating the need to re-measure normal points and thereby reducing examination time.

Inventive Principle:
Principle #2Taking out (Extraction)

2Ease of operation

If perimetry frequency is reduced to decrease examinee burden, then ease of operation is improved, but detection speed of visual field progression deteriorates

Engineering Contradiction:
Improveexaminee burdenVSAvoiddetection speed of visual field progression
Core Design Contradiction:
Ease of operationVSSpeed

Solution Approach 1:

The patent applies local quality by concentrating measurement efforts on specific local areas (subsequent measurement points showing abnormality) rather than uniformly measuring all points. This allows for more frequent targeted assessments of problematic regions while maintaining overall ease of operation, as the focused re-inspection is quicker and less burdensome than complete perimetry.

Inventive Principle:
Principle #3Local quality

Solution Approach 2:

The patent performs preliminary identification of abnormal measurement points through the first comprehensive perimetry. This preliminary action enables subsequent exams to focus only on identified problem areas, allowing for more frequent monitoring of visual field progression without increasing overall examinee burden, since only specific points need re-measurement.

Inventive Principle:
Principle #10Preliminary action

3Measurement precision

If all measurement points are re-measured in subsequent perimetry to maintain comprehensive assessment, then measurement precision is preserved, but examination time and burden increase

Engineering Contradiction:
Improvevisual field assessment accuracyVSAvoidexaminee burden
Core Design Contradiction:
Measurement precisionVSEase of operation

Solution Approach 1:

The patent applies partial action by measuring only the necessary subset of measurement points in subsequent perimetry. Instead of re-measuring all 54-76 points, only the identified subsequent measurement points (typically fewer than 10 points showing P≤5% in the first exam) are re-measured. This partial measurement maintains precision for detecting progression in abnormal areas while significantly reducing examinee burden.

Inventive Principle:
Principle #16Partial or excessive action

Data Source

PatentEP3659493B1perimeter
Publication Date: 2024.01.03 KOWA CO LTD
  • EP3659493B1 patent drawingFigure 1
  • EP3659493B1 patent drawingFigure 2
  • EP3659493B1 patent drawingFigure 3

AI summary

A perimeter 2 capable of acquiring, as a threshold SV, a value corresponding to a response result of a subject 22 to an optotype presented with various brightness, for measurement points set across an entire measurement field of view of the ocular fundus, displaying the threshold SV as a threshold inspection result SHR and storing the same in a memory 13, comprises: a portion 15 for obtaining a pattern deviation PDV of the threshold SV relating to each measurement point RG, from the threshold inspection result SHR; a portion for 15 for obtaining a P value representing the obtained pattern deviation PDV for each measurement point RG as a probability variable, and generating a probability map image MAP4 indicating the measurement points RG separately for each P value; a portion 16 for selecting, from an abnormal measurement point group RG of points in the probability map image MAP4 in which at least a prescribed number of measurement points having a P value at most equal to 5% are continuous, and, of those, for which at least a prescribed number of points have a P value at most equal to 1%, measurement points to be used as subsequent measurement points, until ten points have been reached; and a memory 13 for storing the selected subsequent measurement points, wherein the selection of the subsequent measurement points is controlled in such a way that the measurement points RG are selected from the abnormal measurement point group in order of those having a good pattern deviation PDV.