前房隅角広狭の超音波検査による検討

Ultrasonography in assessment of chamber angle width

　隅角鏡所見は使用する技術や検者の主観に少なからず左右される．所見の客観化をはかるため超音波検査を応用した．細いBモード探触子を利用して眼裂に小型水浸カップを置くだけで前房隅角を断層でとらえ得た．映像プリント上で隅角広を角度で測り，隅角鏡所見と比較した．

　原発緑内障64眼，正常53眼につき検討した．一般に隅角鏡所見と実際の隅角広はあまり一致しなかった．特に隅角鏡で狭隅角と判定された例に両者間の相違が著明で，超音波で計測した隅角角度は必ずしも狭くない例が多かった．隅角鏡で隅角を可視しえないものでも隅角は閉塞していない事が多い．隅角広と前房深の相関も弱くしばしばPlateau irisが証明された．

B-scan ultrasonography was used to quantitate the width of anterior chamber angle in 53 non -glaucomatous and 64 eyes with primary glaucoma. The width of the chamber angle was measured on printed video display and was compared with the gonioscopic findings after Scheie.

Considerable discrepancies were present between the gonioscopic and ultrasonographic findings, par-ticularly in eyes with narrow or shallow chamber angle. In eyes classified as grade II(apex not vis-ible), the actual angle width by ultrasonographyranged from 7ﾟ to 31ﾟ,in grade III(posterior half oftrabeculum not visible) 3ｰ to 26ｰ, and in grade IV (none of angle visible) 0ｰ to 14ｰ. In eyes classified as grade IV, the chamber angle was really closed in only one-third of the cases.

There was a poor correlation between the depth of the anterior chamber and the width of the angle. B-mode ultrasonography clearly demonstrated, whenever present, plateau iris or prominent concen-tric folds of the peripheral iris (Fuchs' roll). Even when gonioscopy failed to show if the angle was open or closed in these eyes, ultrasonography sup-plied reliable informations.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(12) : 1323-1326, 1988