スキャンニングレーザーオフサルモスコープによる網膜神経線維層欠損の観察

Observation of retinal nerve fiber layer defect with scanning laser ophthalmoscope

　新しい眼底観察装置であるscanning laser ophthalmoscope （SLO）による網膜神経線維層欠損の検出について述べた。43眼を調べ，網膜神経線維層欠損検出のsensitivityは77％，specificityは91％であった。SLOは散瞳不十分な患者でも検査が可能であり，リアルタイムで観察された所見がビデオもしくは写真として記録でき，しかもフラッシュを使わないため患者に対する負担も少ない。網膜神経線維層欠損の検出率は，通常のカメラを用いた無赤光撮影に比べて若干落ちるが，十分臨床的な使用に耐えると考えられた。

We observed 43 eyes by a scanning laser ophthal-moscope (SLO, Rodenstock), to detect retinal nerve fiber layer defect (RNFLD). The series com-prised diabetic retinopathy, glaucoma and ischemic optic neuropathy. We used monochromatic lights of helium-neon and argon lasers. The findings were compared with monochromatic photographs taken by conventional fundus camera. SLO led to the detection of RNFLD in 13 out of 17 confirmed eyes, or sensitivity of 77%. There were 2 instances offalse positive finding by SLO in 23 eyes without RNFLD, or specificity of 91%. There were further advantages by monochromatic fundus examination with SLO. It allowed observation through small pupil. Findings were obtained as real-time video images. The patients were comfortable during examinations as SLO required far less intense light for observation. Quality of fundus photograph by SLO was of lesser quality than that by fundus camera. Still, the present SLO system was satisfac-tory in detecting less pronounced RNFLD.