摘要
背景 角膜生物力学特性的改变在青光眼致病过程中有重要作用,但关于不同青光眼类型中角膜生物力学特征的研究较少. 目的 分析原发性慢性闭角型青光眼（CPACG）与原发性开角型青光眼（POAG）患者角膜生物力学特性,总结角膜生物力学在不同房角形态下的特征. 方法 采用前瞻性病例观察研究.纳入2013年12月至2015年10月于中山大学中山眼科中心就诊的CPACG患者68例68眼和POAG患者69例69眼.采用Corvis ST角膜生物力学分析仪实时监测患者角膜形变的动态过程,并测量角膜动态变化过程中的相关生物力学参数.采用Cronbach＇sα系数和组内相关系数（ICC）评估Corvis ST角膜生物力学参数测量结果的可重复性,采用独立样本t检验比较不同房角类型青光眼患者角膜生物力学参数差异,并采用多重线性回归分析探讨角膜生物力学参数与年龄和眼压等的相关性. 结果 2个组间年龄、眼压、性别构成比比较差异均无统计学意义（均P＞0.05）,应用降眼压药物种类数比较差异有统计学意义（t=-2.388,P=0.020）.角膜生物力学主要参数中央角膜厚度（CCT）、最大变形幅度（DA）和最大压陷屈膝峰间距（PD）等的Cronbach＇s α系数和ICC均≥0.8,重复性较好.2个组间CCT、第一次压平时间（A1T）、第一次压平长度（A1L）、第一次压平速度（A1V）、第二次压平时间（A2T）、第二次压平长度（A2L）、第二次压平速度（A2V）和最大变形幅度（DA）比较,差异均无统计学意义（均P＞0.05）;与CPACG患者相比,POAG患者最大压陷时间（HCT）较短,PD较大,最大压陷曲率半径（CCR）较小,差异均有统计学意义（t=2.920,P=0.005;t=-2.453,P=0.017;t=1.997,P=0.050）.DA、A1V、A2T和PD与眼压均呈负相关（r=-0.709、-0.531、-0.645、-0.554,均P＜0.001）,A1T和A2V与眼压均呈正相关（r=0.744、0.546,均P＜0.001）,CCR与CCT呈正相关（r=0.181,P=0.039）.结论 Corv
Background Recent studies have demonstrated that glaucoma progression had great relationship with corneal biomechanical properties.However,there are not enough studies about corneal biomechanical properties in different types of glaucoma.Objective This study was to evaluate the corneal biomechanical properties in chronic primary angle-closure glaucoma （CPACG） and primary open angle glaucoma （POAG）.Methods Prospective observational study was adopted.Sixty-eight cases （68 eyes） with CPACG and 69 POAG patients （69 eyes） from Zhongshan Ophthalmic Center were investigated by a novel technique named Corvis-ST which can measure corneal deformation.The Cronbach＇s αt coefficient and intraclass correlation coefficient （ICC） were used to evaluate the repeatability of the parameters from Corvis-ST.The differences of corneal biomechanical properties between POAG and CPACG were evaluated by independent-samples t test.Multiple regression analysis was used to assess the association between parameters of deformation response and clinical factors.This study protocol was approved by Ethic Committee of Zhongshan Ophthalmic Center and complied with Helsinki Declaration.Written informed consent was obtained from each patient prior to any medical examination.Results There were no statistic differences about age,sex and intraocular pressure （IOP） between CPACG and POAG patients （all at P〉0.05）.However,differences existed in the number of anti-glaucoma medications （t =-2.388,P =0.020）.Measurements of central corneal thickness （CCT）,deformation amplitude （DA）,and peak distance （PD） demonstrated excellent repeatability （ICC≥ 0.8）.There were no statistic differences about CCT,first applanation time/length/velocity （A1 T,A1 L,A1V）,second applanation time/length/velocity （A2T,A2L,A2V）,DA between CPACG and POAG patients （all at P〉 0.05）.The highest concavity time was shorter （t =2.920,P =0.005）,PD was bigger （t =-2.453,P =0.017）,and central curvature radius （CCR）
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2016年第10期930-935,共6页
Chinese Journal Of Experimental Ophthalmology
基金
东莞市科技计划项目（2015105101008）
关键词
青光眼
闭角型/开角型
角膜生物力学
中央角膜厚度
Glaucoma, angle closure/open
Cornea biomechanical properties
Central corneal thickness
