Fundus camera examination

The purpose of a fundus examination during a comprehensive medical check-up (ningen dock) is to detect early-stage lesions in relatively small blood vessels known as arterioles. The fundus (back of the eye) is the only site in the body where the condition of arterioles can be directly observed with the naked eye in a non-invasive manner. By observing the morphology of retinal arteries, one can estimate the condition of arterioles throughout the entire body.

 

To evaluate arteriosclerosis early and non-invasively, there are two primary methods: carotid ultrasound and fundus photography. Carotid ultrasound examines the presence or absence of atherosclerosis (plaque build-up) in relatively large blood vessels. Its progression is influenced by risk factors such as hypertension, hypercholesterolemia, diabetes, and other lifestyle-related diseases, as well as long-term smoking. On the other hand, the arteriolar sclerosis identified through a fundus exam specifically reflects the long-term effects of conditions like high blood pressure. Even without a clear history of hypertension, signs of retinal arteriolar sclerosis are sometimes already detectable in the fundus. Serious conditions such as strokes and myocardial infarctions are believed to involve both arteriolar sclerosis and atherosclerosis in varying degrees. Therefore, in health check-ups aimed at early detection of lifestyle-related diseases and their warning signs, it is preferable to perform both fundus examinations and carotid ultrasounds to thoroughly evaluate arteriosclerosis. If abnormalities are discovered during the examination, reviewing lifestyle habits or starting treatment can help prevent serious illnesses.

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Another primary purpose of a fundus exam is the early detection of diabetic retinopathy caused by diabetes. The appearance of diabetic changes in the fundus is closely related to the onset and prognosis of various systemic complications, making it an essential indicator for determining treatment strategies for diabetes.