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要約 目的:上下の半視野異常がある初期緑内障眼でのスペクトラルドメイン光干渉断層計(OCT)による所見とその意義の報告。対象と方法:広義の原発開放隅角緑内障29例30眼を対象とした。年齢は37~80歳(平均64歳)であり,上下の視野のどちらかに視野異常があった。OCTとしてOptovueのRTVue-100を使い,網膜の構造を定量的に検索した。結果:視野異常がある側では,網膜神経線維層厚と神経節細胞複合体厚が正常側よりも有意に菲薄化していた。神経節細胞複合体厚は緑内障性視野障害を反映する指標であり,視野が正常な側でも19眼(63%)に異常領域があった。結論:スペクトラルドメインOCTでの神経節細胞複合体厚は,半視野異常がある初期緑内障眼での視野異常と相関し,緑内障のごく初期での網膜構造の変化を検出している可能性がある。
Abstract. Purpose:To report the findings and their implications by spectral domain optical coherence tomography(OCT)in eyes of early glaucoma with hemifield defect. Object and Method:This study was made on 30 eyes of 29 patients with primary open-angle glaucoma in the broad sense. The age ranged from 37 to 80 years,average 64 years. All the eyes had visual field defect either in the superior or inferior hemisphere. Structure of the retina was evaluated using an OCT,RTVue-100 by Optovue. Result:The affected hemisphere showed significant attenuation in the thickness of retinal nerve fiber layer and ganglion cell complex. Thickness of ganglion cell complex was found to be a parameter for glaucomatous visual field defect even in its early stage. Abnormal area in the thickness was present in the hemisphere with apparently unaffected visual field in 19 eyes(63%). Conclusion:Spectral domain OCT has shown that thickness of ganglion cell complex is correlated with visual field defect in eyes with early-stage glaucoma. The OCT findings may reflect structural changes in the retina in the initial phase of glaucoma.
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