広画角デジタル眼撮影装置（RetCam®）による隅角検査の試み

Goniophotography using RetCam®, a wide-field digitalized camera

要約　目的：広隅角デジタル撮影装置であるRetCam^®を用いた隅角検査の報告。対象と方法：手術のために入院した緑内障患者50名50眼を対象とした。Goldmann 2面隅角鏡とRetCam^®で各4方向の隅角を撮影し，その結果を比較した。隅角の広さの判定にはScheieの分類を用いた。結果：隅角鏡とRetCam^®で判定される隅角の広さは，Grade 0とIの広隅角では100％で一致し，隅角が狭くなるにつれ一致率が低下し，RetCam^®によるほうが広く判定された。RetCam^®による圧迫隅角検査は容易で，周辺虹彩前癒着の有無の判定が可能であった。結論：RetCam^®で隅角の撮影記録ができた。RetCam^®では撮影時に眼球が圧迫されやすく，狭隅角眼では隅角の広さの定量的評価が困難である。

Abstract.　Background：RetCam^® is a wide-field digitalized imaging system and is mainly used for fundus photography in infants and children. Purpose：To report the use of RetCam^® for goniophotography in glaucomatous eyes. Cases and Method：This study was made on 50 eyes of 50 patients of glaucoma prior to surgery. Each eye received photography of the chamber angle in 4 quadrants using Goldmann two-mirror goniolens and RetCam^® in sitting position. Results：There was a 100％ agreement in the width of the angle between goniolens and RetCam^® in eyes with narrow angle graded as 0 or Ⅰ by Scheie classification. The rate of agreement decreased in eyes with wider angle, as RetCam^® tended to show a wider grading than goniolens. It was easy to perform depression gonioscopy with RetCam^® and to identify peripheral goniosynechia. Conclusion：It was possible to perform goniophotography using RetCam^®. Objective evaluation of the width of chamber angle was difficult when using RetCam^® due to compression of the eyeglobe.