走査型レーザー検眼鏡（SLO）による回旋偏位の解析—上下斜視の自覚的回旋偏位と他覚的回旋偏位の比較

Evaluation of cyclodeviation by scanning laser ophthalmoscope:Comparison of subjective and objective cyclodeviation in vertical strabismus

　自覚的回旋偏位と他覚的回旋偏位の関係を51例の上下斜視について検討した。自覚的偏位についてはHarmsの正切に回旋計測器を組み合わせた方法で，他覚的偏位については走査型レーザー検眼鏡で得られた画像から，乳頭図心と中心窩を結ぶ線と水平線のなす角度を計測して決定した。後天性麻痺例ならびに20歳以降に自覚症状が出現し治療を必要とした先天性麻痺例では，自覚的と他覚的回旋偏位の間に有意な相関があった（p＝0.0007,p＜0.0001）。20歳以下の先天性麻痺例では有意な相関はなかった（p＞0.05）。先天性麻痺例の自覚的および他覚的偏位の差は，成人例のほうが若年例よりも比較的小さかった。

We studied the relationship between subjective and objective cyclodeviation in 51 cases with vertical strabismus. Subjective cyclodeviation was evaluated by a cyclodeviometer combined with the tangent screen of Harms. Objective cyclodeviation was evaluated by measuring the angle formed by the horizontal line and the line running through the fovea and the center of the optic disk as seen as the fundus image by a scanning laser ophthalmoscope. There was a significant correlation between the subjective and objective cyclodeviation in patients with recent-onset acquired palsy (p=0.0007), and in patients of congenital palsy who sought medical advice for complaints after 20 years of age (p ＜ 0.0001) . There was no significant correlation in patients with congenital palsy manifesting before 20 years of age (p ＞0.05). The findings show that the discrepancy between subjective and objective cyclodeviation in congenital palsy is relatively smaller in adult patients than in younger ones.