網膜神経線維層観察におけるレーザー走査型検眼鏡の評価

Clinical evaluation of laser scanning ophthalmoscope for detection of retional nerve fiber layer defect

　カールツァイス社製confocal laser scanning ophthalmoscope（CLSO）を用い，網膜神経線維層欠損（RNFLD）の検出について検討した。無赤色光眼底撮影に比較すると，CLSOによるRNFLDの検出の敏感度は88％（30眼／34眼），特異度は76％（13眼／17眼）であった。無赤色光眼底撮影には，眼底カメラ内蔵の螢光造影用干渉フィルターとKodak wrattenフィルタ44Aを使用したが，励起フィルターの違いによる画質の差はなかった。CLSOによるRNFLDの観察は，リアルタイムにモニターに写し出された画像が出力でき，カールツァイス社製CLSOは検眼鏡としての能力が高いと思われた。

We studied 61 eyes of glaucoma to detect retinal nerve fiber layer defect (NFLD) with a confocal laser scanning ophthalmoscope (CLSO) by Zeiss. When compared with red-free fundus photo-graphs, the sensitivity of NFLD detection by CLSO was 88% and specificity was 76%. There was no difference in the rate of detection whether the examination was made under mydriasis or not. For red-free fundus photography, we used two filters: narrow-band interference filter and Kodak wratten filter. The image quality was the same for CLSO and red-free fundus photographs. Use of CLSO in detecting NFLD enabled observation of findings as real-time image, instant printout and three-dimensional analysis in addition to fluorescein angiography whenever necessary. The present method seemed to be useful in the quantitative study of glaucoma.