Image processing device (50) of the present invention comprises: an enhancement processing means (51) that enhances a speckle pattern in an ocular fundus tomographic image； a region-of-interest setting means (52) that sets a desired region in the ocular fundus tomographic image with the enhanced speckle pattern as a region-of-interest； a feature value extracting means (53) that extracts a feature value of the speckle pattern in the region-of-interest； and a disease determining means (54) that makes disease determination for an ocular fundus on the basis of the feature value. Image processing method of the present invention comprises: a step (S3) of enhancing a speckle pattern in an ocular fundus tomographic image； a step (S4) of setting a desired region in the ocular fundus tomographic image with the enhanced speckle pattern as a region-of-interest； a step (S5) of extracting a feature value of the speckle pattern in the region-of-interest； and a step (S6) of making disease determination for an ocular fundus on the basis of the feature value.
