スペクトラルドメイン光干渉断層計による黄斑部および視神経乳頭周囲網膜神経線維層厚と視野障害の相関

Correlation between visual field loss and thickness of retinal nerve fiber layer in the peripapillary and macular area by spectral domain optical coherence tomography

要約　目的：緑内障での視野障害と，スペクトラルドメイン光干渉断層計（OCT）で計測した黄斑部と乳頭周囲での網膜神経線維層厚との相関の報告。対象と方法：広義の原発開放隅角緑内障45眼と正常眼32眼を対象とした。視野はHumphrey視野計で測定し，中心30-2プログラムのMD値で評価した。結果：乳頭周囲と黄斑部の網膜神経線維層厚は緑内障の病期とともに有意に減少した（p＜0.01）。各症例での値はそれぞれのMD値と強く相関した（r＝0.718，r＝0.620）。MD値による緑内障の病期分類と網膜神経線維層厚は，乳頭周囲では中期以降，黄斑部では初期群で相関があった（r＝0.659，r＝0.326）。結論：黄斑部と乳頭周囲での網膜神経線維層厚は緑内障の進行とともに減少した。初期緑内障の診断では，黄斑部の網膜神経線維層厚が有用な指標となる可能性がある。

Abstract.　Purpose：To report the correlation between visual field loss and retinal nerve fiber layer thickness（NFLT）in the peripapillary and macular area measured by spectral domain optical coherence tomography. Objects and Method：This study was made on 45 eyes of primary open-angle glaucoma and 32 normal eyes. Visual field was evaluated by MD value measured by Humphrey perimetry. Results：NFLT in both areas significantly decreased along with progression of glaucoma（p＜0.01）. The value in both areas was correlated with MD value（r＝0.718,r＝0.620）. Significant correlations were present between MD and NFLT in the peripapillary area in middle and more advanced stage（r＝0.659）,and between MD and NFLT in the macular area in the early stage（r＝0.326）. Conclusion：NFLT in the peripapillary and macular area decreased along with progression of glaucoma. NFLT in the macular area promises to be of value in the diagnosis of early glaucoma.