摘要
目的探索角膜生物力学分析仪(Corvis ST)及微视野计(MP-3)在原发性开角型青光眼(POAG)患者早期诊断与病情评估中的应用价值。方法回顾性临床研究。选取2021年3月至10月于郑州大学第一附属医院眼科就诊的POAG患者68例102眼(轻度POAG组45眼,中度POAG组36眼,重度POAG组21眼)及同期健康体检者(对照组)30例30眼为研究对象。分析4组间角膜生物力学参数、黄斑区平均光敏感度(MS)、固视稳定性的差异,利用受试者工作特征(ROC)分析角膜生物力学参数的预测性能,并对角膜生物力学参数与MS进行相关性分析。结果轻度、中度、重度POAG组患者及对照组受试者4组间角膜第一压平时间(A1T)、第一压平速度(A1V)、第二压平时间(A2T)、最大压陷曲率半径(CCR)、角膜硬度参数(SP-A1)的差异均具有统计学意义(均为P<0.05),ROC分析得出其对应的曲线下面积分别为0.804、0.734、0.873、0.675、0.521,其中A2T是对POAG预测价值较高的指标。黄斑区各象限及总体MS在对照组受试者和轻度、中度、重度POAG组患者间均呈逐渐降低趋势(均为P<0.05),中央及颞下象限MS最易受累。轻度、中度POAG组患者2°固视率均低于对照组(均为P<0.05),4°固视率与对照组相比差异均无统计学意义(P=0.210、0.079),重度POAG组患者的2°、4°固视率均低于对照组(均为P<0.05)。A2T与颞下象限MS呈正相关(P=0.010),CCR与各象限及总体MS均呈正相关(均为P<0.05),SP-A1与鼻上象限MS呈正相关(P=0.012)。结论POAG患者会出现角膜生物力学参数的改变及黄斑区MS和固视稳定性的降低。角膜生物力学分析仪及微视野计检查均有助于对POAG的早期诊断及病情评估。
Objective To explore the effect of corneal biomechanics analyzer(Corvis ST)and microperimeter(MP-3)in the early diagnosis and assessment of primary open-angle glaucoma(POAG).Methods In this retrospective clinical study,102 eyes of 68 patients with POAG(45 eyes in the mild POAG group,36 eyes in the moderate POAG group,and 21 eyes in the severe POAG group)and 30 eyes of 30 healthy controls(control group)who attended the Ophthalmology Department of the First Affiliated Hospital of Zhengzhou University from March 2021 to October 2021.The differences in corneal biomechanical parameters,mean sensitivity(MS)in the macula,and fixation stability between the 4 groups were analyzed.The predictive performance of corneal biomechanical parameters was evaluated using receiver operating characteristic(ROC),and the correlation between corneal biomechanical parameters and MS was analyzed.Results There were significant differences in the first applanation time(A1T),first applanation velocity(A1V),second applanation time(A2T),central curvature radius(CCR)and stiffness parameter at first applanation(SP-A1)among the four groups(all P<0.05).ROC analysis results showed the areas under the ROC curve of the said parameters were 0.804,0.734,0.873,0.675 and 0.521,respectively and A2T presented a higher predictive value for POAG.MS in all quadrants of the macula and the overall MS of patients in the four groups were gradually lower(all P<0.05),with MS in the central and inferior temporal quadrants being most susceptible to involvement.The rates of 2°fixation in patients with mild and moderate POAG were lower than those in the controls(all P<0.05),while the rates of 4°fixation were not significantly different(P=0.210,0.079).The rates of 2°and 4°fixation in patients with severe POAG were lower than those in the controls(all P<0.05).A2T was positively correlated with MS in the inferior temporal quadrant(P=0.010),CCR was positively correlated with MS in all quadrants and the overall MS(all P<0.05),and SP-A1 was positively correlated with MS
作者
刘欣
杨琳
谭凤玲
刘畅
尚玥
吕勇
LIU Xin;YANG Lin;TAN Fengling;LIU Chang;SHANG Yue;LÜYong(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)
出处
《眼科新进展》
CAS
北大核心
2022年第4期304-309,共6页
Recent Advances in Ophthalmology
基金
河南省高等学校重点科研项目(编号18A320035)。
关键词
原发性开角型青光眼
角膜生物力学参数
微视野计
光敏感度
固视稳定性
primary open-angle glaucoma
corneal biomechanical parameters
microperimeter
mean sensitivity
fixation stability
