走査レーザー検眼鏡を用いた黄斑円孔のスコトメトリー

Scotometry in eyes with macular hole using a scanning laser ophthalmoscope

　走査レーザー検眼鏡を用いたスコトメトリー装置は，眼底観察下に任意の部位の網膜感度の測定が可能である。本装置により黄斑円孔例の暗点測定を行った。黄斑円孔10例11眼の全例に円孔部の絶対暗点と，円孔周囲のfluid cuff部に比較暗点がみられ，比較暗点の領域内でも，固視点の部の網膜感度は比較的良好に保たれていた。硝子体手術により円孔が完全に閉鎖した7例7眼の全例で，円孔部の絶対暗点は消失した。偽黄斑円孔6例6眼全例においては，円孔部に絶対暗点はなかった。本装置は，黄斑円孔と偽黄斑円孔との鑑別，黄斑円孔の病態および手術効果の評価の上で有用と考える。

Eleven eyes with full-thickness macular hole were examined by scotometry using a scanning laser ophthalmoscope under direct observation of the fundus. All the eyes showed an absolute scotoma within the macular hole area and a relative scotoma in the surrounding fluid cuff. The point of fixation was located in the cuff area and showed relatively good sensitivity. The absolute scotoma disappeared in 7 successfully operated eyes. No absolute scotoma was present in another series of 6 eyes with pseudomacular hole. The present method promises to be of value in differentiating true macular hole from pseudoholes, in evaluating the pathophysiology of holes, and in assessing the outcome of surgery.