目的:探讨双眼眼前节生物学参数的差值对早期圆锥角膜的诊断价值。方法:回顾性对照研究。选取2022-03/2023-11在我院就诊的患者183例366眼,其中亚临床期圆锥角膜组40例80眼,临床期圆锥角膜组36例72眼,单纯屈光不正患者107例214眼作为对...目的:探讨双眼眼前节生物学参数的差值对早期圆锥角膜的诊断价值。方法:回顾性对照研究。选取2022-03/2023-11在我院就诊的患者183例366眼,其中亚临床期圆锥角膜组40例80眼,临床期圆锥角膜组36例72眼,单纯屈光不正患者107例214眼作为对照组,均采用Pentacam眼前节分析仪检测双眼角膜后表面下方与上方3 mm屈光力差值(I-S),角膜后表面最薄点高度(P.E.),最佳拟合球体的最大后表面高度(MPE from BFS)、最佳拟合复曲面椭圆体的最大后表面高度(MPE from BFTE)、角膜后表面非球面不对称指数(AAI)、角膜中央厚度(CCT)、角膜最薄点厚度(TCT)、角膜平均厚度进展(PPIavg)、角膜厚度最大变化率(ARTmax)、Belin/Ambrósio增强扩张显示总偏差值(BAD-D),并分别计算每例患者各检测指标的双眼差值。对照组根据角膜直径进一步分为:角膜直径<11.2 mm组21例42眼;11.2 mm≤角膜直径≤11.8 mm组54例108眼;角膜直径>11.8 mm组32例64眼。结果:临床期圆锥角膜组与对照组双眼I-S、P.E.、MPE from BFS、MPE from BFTE、AAI、CCT、TCT、PPIavg、ARTmax、BAD-D差值均有差异(P<0.05);双眼I-S、P.E.、MPE from BFS、MPE from BFTE、AAI、CCT、TCT、PPIavg、BAD-D差值对圆锥角膜诊断价值较高(AUC≥0.900),其中P.E.、BAD-D诊断能力最佳,AUC分别高达0.999和0.995。亚临床期圆锥角膜组与对照组的双眼P.E.、ARTmax差值有差异(P<0.05);双眼I-S、P.E.、BAD-D差值对亚临床期圆锥角膜诊断价值较高(AUC≥0.900)。对照组患者不同角膜直径组比较双眼角膜I-S、CCT、TCT、MPE from BFS、MPE from BFTE、AAI、PPIavg、ARTmax均无差异(均P>0.05),且均与角膜直径无相关性(P>0.05);不同角膜直径组双眼P.E.、BAD-D差值比较有差异(P=0.007、0.003),而双眼P.E.差值与角膜直径无相关性(P=0.270),双眼BAD-D差值与角膜直径负相关(r=-0.230,P=0.017)。结论:Pentacam眼前节分析仪可以准确测量多种角膜生物学参数,双眼I-S、P.展开更多
AIMTo examine the occurrence of commonly known clinical signs of keratoconus (KC), i.e. Fleischer ring, prominent corneal nerves and thinning, among unaffected family members of KC patients and healthy control individ...AIMTo examine the occurrence of commonly known clinical signs of keratoconus (KC), i.e. Fleischer ring, prominent corneal nerves and thinning, among unaffected family members of KC patients and healthy control individuals.METHODSData of both eyes of 117 relatives of KC patients having no manifest disease based on videokeratography indices (KC relatives), and 142 controls were used for Pearson correlation and t-test statistics. Correlation of Fleischer ring, prominent corneal nerves and central pachymetry data were tested with each other and with videokeratography indices (KSI, KISA, 3 and 6 mm Fourier asymmetry, and I-S).RESULTSA moderate correlation was found between Fleischer ring and all examined topographical indices. Most important correlation was present with 6 mm Fourier asymmetry, and corneal pachymetry (r=0.272, P<0.001; r=-0.234, P=0.027, respectively). Similar correlations were found with prominent corneal nerves (r=0.234, P<0.001 for 6 mm Fourier asymmetry and r=-0.235, P=0.0265 for pachymetry). KC family members who exhibited Fleischer ring or prominent nerves had thinner and more asymmetric corneas than those without Fleischer ring or prominent corneal nerves (P<0.05 for pachymetry and topographic indices with t-test and Mann-Whitney rank sum test). Though rarely, Fleischer ring and prominent corneal nerves occurred among normal controls, indicating the existence of forme fruste cases in the normal population. Control subjects, who had corneal Fleischer ring or prominent nerves had corneas more similar to KC than other controls (t-test: increased KSI and KISA, P=0.048 and 0.012, respectively).CONCLUSIONIn KC family members and healthy individuals, Fleischer ring and prominent corneal nerves are associated with features of KC and may suggest a possibility of forme fruste KC. Searching for the possible presence of Fleischer ring or prominent nerves on the cornea may help in the decision whether or not to diagnose subclinical KC in a borderline case.展开更多
文摘目的:探讨双眼眼前节生物学参数的差值对早期圆锥角膜的诊断价值。方法:回顾性对照研究。选取2022-03/2023-11在我院就诊的患者183例366眼,其中亚临床期圆锥角膜组40例80眼,临床期圆锥角膜组36例72眼,单纯屈光不正患者107例214眼作为对照组,均采用Pentacam眼前节分析仪检测双眼角膜后表面下方与上方3 mm屈光力差值(I-S),角膜后表面最薄点高度(P.E.),最佳拟合球体的最大后表面高度(MPE from BFS)、最佳拟合复曲面椭圆体的最大后表面高度(MPE from BFTE)、角膜后表面非球面不对称指数(AAI)、角膜中央厚度(CCT)、角膜最薄点厚度(TCT)、角膜平均厚度进展(PPIavg)、角膜厚度最大变化率(ARTmax)、Belin/Ambrósio增强扩张显示总偏差值(BAD-D),并分别计算每例患者各检测指标的双眼差值。对照组根据角膜直径进一步分为:角膜直径<11.2 mm组21例42眼;11.2 mm≤角膜直径≤11.8 mm组54例108眼;角膜直径>11.8 mm组32例64眼。结果:临床期圆锥角膜组与对照组双眼I-S、P.E.、MPE from BFS、MPE from BFTE、AAI、CCT、TCT、PPIavg、ARTmax、BAD-D差值均有差异(P<0.05);双眼I-S、P.E.、MPE from BFS、MPE from BFTE、AAI、CCT、TCT、PPIavg、BAD-D差值对圆锥角膜诊断价值较高(AUC≥0.900),其中P.E.、BAD-D诊断能力最佳,AUC分别高达0.999和0.995。亚临床期圆锥角膜组与对照组的双眼P.E.、ARTmax差值有差异(P<0.05);双眼I-S、P.E.、BAD-D差值对亚临床期圆锥角膜诊断价值较高(AUC≥0.900)。对照组患者不同角膜直径组比较双眼角膜I-S、CCT、TCT、MPE from BFS、MPE from BFTE、AAI、PPIavg、ARTmax均无差异(均P>0.05),且均与角膜直径无相关性(P>0.05);不同角膜直径组双眼P.E.、BAD-D差值比较有差异(P=0.007、0.003),而双眼P.E.差值与角膜直径无相关性(P=0.270),双眼BAD-D差值与角膜直径负相关(r=-0.230,P=0.017)。结论:Pentacam眼前节分析仪可以准确测量多种角膜生物学参数,双眼I-S、P.
基金Supported by Hungarian National Research Fund Grants OTKA F046321 and TAMOP-4.2.1/B-09/1/KONV-2010-0007
文摘AIMTo examine the occurrence of commonly known clinical signs of keratoconus (KC), i.e. Fleischer ring, prominent corneal nerves and thinning, among unaffected family members of KC patients and healthy control individuals.METHODSData of both eyes of 117 relatives of KC patients having no manifest disease based on videokeratography indices (KC relatives), and 142 controls were used for Pearson correlation and t-test statistics. Correlation of Fleischer ring, prominent corneal nerves and central pachymetry data were tested with each other and with videokeratography indices (KSI, KISA, 3 and 6 mm Fourier asymmetry, and I-S).RESULTSA moderate correlation was found between Fleischer ring and all examined topographical indices. Most important correlation was present with 6 mm Fourier asymmetry, and corneal pachymetry (r=0.272, P<0.001; r=-0.234, P=0.027, respectively). Similar correlations were found with prominent corneal nerves (r=0.234, P<0.001 for 6 mm Fourier asymmetry and r=-0.235, P=0.0265 for pachymetry). KC family members who exhibited Fleischer ring or prominent nerves had thinner and more asymmetric corneas than those without Fleischer ring or prominent corneal nerves (P<0.05 for pachymetry and topographic indices with t-test and Mann-Whitney rank sum test). Though rarely, Fleischer ring and prominent corneal nerves occurred among normal controls, indicating the existence of forme fruste cases in the normal population. Control subjects, who had corneal Fleischer ring or prominent nerves had corneas more similar to KC than other controls (t-test: increased KSI and KISA, P=0.048 and 0.012, respectively).CONCLUSIONIn KC family members and healthy individuals, Fleischer ring and prominent corneal nerves are associated with features of KC and may suggest a possibility of forme fruste KC. Searching for the possible presence of Fleischer ring or prominent nerves on the cornea may help in the decision whether or not to diagnose subclinical KC in a borderline case.
