摘要
目的 探讨正常眼压性青光眼（NTG）角膜生物力学参数与视野损伤进展的关系,并评估可视化角膜生物力学分析仪（Corvis-ST）测得的角膜生物力学参数对视野损伤进展的预测效力.方法 前瞻性病例观察研究.收集2014年5月至2015年10月于北京大学第一医院眼科确诊为NTG的患者,纳入随访时间〉18个月且有5次以上视野检查结果的患者.采用Corvis-ST检测患者的角膜生物力学参数.根据有无视野进展（3次以上连续随访的视野检查中,进展期青光眼干预研究评分与单次基线视野相比均增加4分及以上）将患者分为有进展组和无进展组.采用独立样本t检验、Mann-Whitney U检验对两组患者的角膜生物力学参数进行比较;采用Spearman相关性分析对角膜生物力学参数与视野损伤进展的相关性进行分析;采用受试者工作特征（ROC）曲线分析角膜生物力学参数对视野损伤进展的预测效力.结果 60例患者中符合条件者共37例（37只眼）,其中男性12例（12只眼）,女性25例（25只眼）,年龄（61.6±11.0）岁.进展组10例（10只眼）,无进展组27例（27只眼）.两组之间的年龄、中央角膜厚度、眼轴长度、基线眼压、基线视野等差异均无统计学意义（t=-1.997, 0.728,-0.745,1.264,-0.136;P〉0.05）.进展组第一压平时间（Time A1）为（7.10±0.17）ms,无进展组为（7.37±0.28）ms,差异有统计学意义（t=-3.357,P=0.002）.进展组第一压平长度（Length A1）为1.74 （1.61,1.77）mm,无进展组为1.78（1.77,1.79）mm,差异有统计学意义（Z=-3.036,P=0.002）.而进展组与无进展组相比,第一压平速率（Velocity A1）[0.16（0.14,0.16）和0.15（0.14,0.15）m/s, Z=-2.627,P=0.009]及最大形变幅度（Def Ampl HC）[（1.22±0.13）和（1.12±0.11）mm,t=2.601,P=0.013]更大.相关性分析显示,Time A1、Length A1、Velocity A1及DefAmpl HC与视野损伤进展均有相关性（r=-0.521,-0.463,0.401,0.349;P〈0.05）.ROC曲�
Objective To evaluate the association between corneal biomechanical parameters and visual field（VF）progression in normal tension glaucoma（NTG）using the Corvis-ST device,and to evaluate the ability of corneal biomechanical parameters to predict the VF progression. Methods Corneal biomechanical parameters of newly diagnosed NTG patients were obtained using Corvis-ST in the baseline follow-up visit. The VF progression was defined as a 4-point increase in the Advanced Glaucoma Intervention Study （AGIS） score compared to the baseline in three consecutive follow-up visits （per 3-6 months）.Corneal biomechanical parameters were compared between progressive and nonprogressive VF loss eyes using the independent-sample t test and Mann-Whitney U test.Spearman correlation analysis was used to explore the relationship between the corneal biomechanical parameters and the VF progression.Receiver operating characteristic curves were studied for the parameters and the sensitivity and specificity for distinguishing between progressive and nonprogressive glaucomatous eyes. The areas under the receiver operating characteristic curves（AUC）were also evaluated.Results Sixty patients with NTG were enrolled in this study.Among them,12 were lost to follow-up.A total of 48 patients completed all follow-up visits on schedule.Eleven of them were excluded due to one or more uncontrolled intraocular pressure（IOP）during the follow-up （less than 30% IOP reduction from the baseline）. Thirty-seven eyes of 37 diagnosed NTG patients were enrolled.Ten eyes reached a progression endpoint.There was no significant difference in age, central corneal thickness, axial length, baseline IOP or baseline VF between the two groups. There was significant difference in Time A1[（7.10±0.17）ms vs.（7.37±0.28）ms,t=-3.357,P=0.002],Length A1[1.74 （1.61, 1.77） mm vs. 1.78（1.77, 1.79） mm, Z=-3.036, P=0.002], Velocity A1 [0.16（0.14, 0.16） m/s vs. 0.15 （0.14,0.15）m/s,Z=-2.627,P=0.009]and DefAmpl HC[（1.22 ± 0.13）mm vs
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2018年第3期171-176,共6页
Chinese Journal of Ophthalmology
关键词
青光眼
角膜
生物物理学现象
视野
眼压
Glaucoma
Cornea
Biophysical phenomena
Visual fields
Intraocular pressure
