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要約 目的:Waterclefts(WC)が存在する領域および範囲を,前眼部光干渉断層計を使用して調査する。
対象と方法:対象は加齢白内障術前の203眼(男性90眼,女性113眼:62〜89歳)。まず前眼部解析装置(KATS-1000:コーナン・メディカル社)を使用して徹照法で撮影後,WCが観察できた例を選別する。次に,前眼部光干渉断層計(ANTERION:Heidelberg Engineering社)で選別例の撮影を行い,WCの存在領域を調査する。
結果:WCの発症頻度は25.1%であり,以下の4グループに分けることができた。①瞳孔領中央の直径3mm内の前囊下あるいは後囊下皮質にWCが観察可(9眼),②径3mmを超えて前囊下あるいは前・後囊下皮質にWCが観察可(17眼),③径3mm内にWCは存在せず,径3mm外に観察可(1眼),④前囊下あるいは前・後囊下皮質にWCが観察可で,前囊下では皮質混濁も混在する。そして前囊下のWC領域は径3mmを超える(24眼)。
結論:KATS-1000の徹照画像でWCが観察できた例のみを対象として調査したが,ANTERIONで撮影した画像ではWCの存在領域や範囲,そして皮質混濁との位置関係を明確に把握することができるため,本観察法はWCの診断に有用と考えた。
Abstract Purpose:To investigate the region and area of waterclefts(WC)in the images obtained from an anterior segment optical coherence tomography device.
Participants and methods:The study involved 203 eyes(90 eyes of men, 113 eyes of women)of patients(age:62-89 years)scheduled for cataract surgery. Initial imaging was performed using a transillumination method with an anterior segment analysis device(KONAN KATS-1000), and cases of WC were selected. Subsequently, selected eyes were further imaged using an anterior segment optical coherence tomography device(Heidelberg Engineering ANTERION)to assess the area of the WC.
Results:1)WC were observed in the anterior or anterior and posterior cortex within a 3-mm diameter at the center of the pupillary area in 9 eyes. 2)WC larger than 3 mm in diameter were noted in the anterior or anterior and posterior cortex in 17 eyes. 3)In one eye, WC were not observed within the 3-mm diameter but were detected outside this region. 4)In 24 eyes, WC were visible in the anterior or anterior and posterior cortex, with a cortical opacity also present beneath the anterior capsule. Notably, the WC under the anterior capsule exceeded 3 mm in diameter. Overall, WC were identified in 25.1% of all cases.
Conclusion:Although targets of this study were patients with wc observed in the images using KATS-1000, investigated images captured using an anterior segment optical coherence tomography device provide a clearer and more comprehensive understanding of the area and extent of WC, which is valuable of diagnosis of this cataract subtype.

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