近視緑内障眼における黄斑部網膜神経節細胞層関連層厚と視野障害の関係

Correlation between visual field defect and thickness of ganglion cell-inner plexiform layer in the macula in myopic eyes with glaucoma

要約　目的：近視緑内障眼の黄斑部網膜神経節細胞層厚＋内網状層（GCIPL）厚と視野障害との関係の報告。対象と方法：対象は屈折が－3.00D以下の緑内障眼39眼で，早期19眼，中期以降20眼，近視型乳頭16眼を抽出。光干渉断層計（OCT）で，GCIPL厚解析（GCA）を施行し，視野障害との相関を検討。結果：早期で視神経乳頭周囲平均網膜神経線維層厚（Avg. RNFL）の他3個のGCAパラメータ，中期以降で他4個のGCAパラメータと正の相関，近視型乳頭ではAvg. RNFLと相関がなく，2個のGCAパラメータと正の相関があった。結論：近視緑内障眼でGCAは中期以降や乳頭変形がある症例にも応用可能である。

Abstract.　Purpose：To report the correlation between macular ganglion cell-inner plexiform layer（GCIPL）thickness and visual field loss in myopic glaucomatous eyes measured by spectral domain optical coherence tomography（SD-OCT）using GCIPL thickness analysis program（GCA）. Cases and Method：This study was made on 39 eyes of open angle glaucoma with myopia grater than －3 diopters. There were 19 eyes with early stage, 20 eyes with medium and advanced stages in classified by Anderson and Patella's criteria, and 16 eyes with myopic-type disc. We studied mean deviation（MD）with Humphrey field analyzer and the correlation with thickness parameters. All the eyes were evaluated for average circumpapillary retinal nerve fiber layer（Avg. RNFL）and GCIPL using an SD-OCT. Results：The Avg. RNFL and three parameters from GCA were positively correlated with MD in early stage group. The Avg. RNFL and four GCA parameters were positively correlated in medium and advanced stages group（p＜0.05）. In eyes with myopic-type disc, there was no correlation with between MD and Avg. RNFL, and positive correlation with two GCA parameters（p＜0.05）. Conclusion：GCA was useful for diagnosis of myopic glaucomatous eyes in not only early stage, and useful for myopic-type disc.