光干渉断層計による網膜神経線維層厚と緑内障性視野障害の関係

Relation between glaucomatous visual field loss and retinal nerve fiber layer thickness measured by optical coherence tomography

（B5-2-20）　光干渉断層計（OCT）を用いて緑内障眼における乳頭周囲網膜神経線維層（RNFL）厚の解析を行い，視野との相関性について検討した。対象は高眼圧症患者4例4眼と緑内障患者31例47眼で，各々の症例にOCTで視神経乳頭周辺を円周状にスキャンし，動的および静的視野計測を行った。湖崎分類の平均RNFL厚の比較では，初期に差がなく，中期で有意な減少を示したが，Aulhorn分類では病期が進むごとになだらかな減少を示した。静的視野計測で得られたmean deviation（mean defect）とRNFL厚との間には有意な相関性がみられた（r＝0.73〜0.88,p＜0.0001）。早期の視野変化を示す緑内障眼では，blue-on-yellow視野計やslze Iの視標を用いた白色視野計の結果とOCT所見が補助診断に有用であった。

We evaluated 51 eyes regarding glaucomatous visual field loss and retinal nerve fiber layer thickness (RNFL) as measured by optical coherence tomography (OCT) . The series comprised 4 eyes of ocular hypertension and 47 glaucoma eyes. Each eye was scanned circularly around the optic disc and was tested by kinetic and static perimetry. Eyes in the early stage of visual field loss by the Kosaki Classification showed no difference in the mean RNFL thickness. Eyes in the middle stages showed significant reduction in the thickness. The RNFL thickness decreased along with the grading by the Aulhorn Classification. The mean deviation (mean defect) by static perimetry was significantly correlated with the RNFL thickness (r = 0.73-0.88, p ＜ 0.0001). The findings show that OCT is of value as adjunct to blue-on-yellow perimetry and white-on-white perimetry using size I stimulus in the diagnosis of early glaucomatous visual field defects.