眼科検診において判定可能な眼科データが得られる割合についての検討

Incidence of meaningful data among five examinations in ophthalmological check-up program for adults

要約　目的：成人眼科検診で実施した5項目の検査につき，それぞれで信頼度が高い結果が得られた頻度を報告する。

対象と方法：成人眼科検診をさど眼科で受けた173例346眼を対象とした。男性50例，女性123例で，年齢は40〜74歳，平均61歳であった。無散瞳倒像眼底検査，無散瞳眼底撮影，光干渉断層計（OCT）による網膜神経線維層（RNFL）の厚さの測定，OCTによる網膜神経節細胞群（GCC）の解析と黄斑断面の撮影，ハンフリーの装置（HFA）による視野解析の5項目の検査が各症例で行われた。倒像眼底検査と眼底写真の撮影は眼科医が行い，他の3項目は視能訓練士が行った。

結果：検査結果の判定可能割合は，倒像眼底検査が最も高く，GCC，RNFL，眼底写真，HFAがこれに続いた。眼底撮影については，約11％で判定不能であった。

結論：これからの成人眼科検診では，検査の判定ができる頻度を考慮し，感度と特異度を確認したうえで検査項目を選ぶべきである。

Abstract　Purpose：To report the incidence of meaningful data among five examinations in ophthalmological check-up program for adults.

Cases and Method：This study was made on 346 eyes of 173 cases who received ophthalmological check-up program for adults at Sado Eye Clinic. The series comprised 50 males and 123 females. The age ranged from 40 to 74 years and averaged 61 years. Each case received 5 examinations as follow. No-mydriasis inverted funduscopy, no-mydriasis fundus photography, measurement of thickness of retinal nerve fiber layer（RNFL）by means of optical coherence tomography（OCT）, analysis of ganglion cell complex（GCC）by OCT and simultaneous photography of the macula, and visual field test using Humphrey Field Analyzer（HFA）. Funduscopy and fundus photography was performed by ophthalmologist. The other three examinations were performed by orthoptist.

Results：Meaningful data was most frequently obtained by funduscopy, followed by GCC, RNFL, fundus photography and HFA in the declining order. About 11％ of fundus photographs were useless due to poor quality.

Conclusion：Examinations in ophthalmological check-up program are to be decided regarding the availability of meaningful data as well as the sensitivity and specificity.