角膜地形图、厚视术和高阶像差对亚临床圆锥角膜的检测价值评价。

Sandeep Kandel, Meenu Chaudhary, Sanjeeb K Mishra, Niraj D Joshi, Manish Subedi, Prajjol R Puri, Parash Gyawali, Jeewanand Bist, Himal Kandel
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引用次数: 5

摘要

目的:比较角膜变形眼和正常眼的角膜地形图、视厚和高阶像差;探讨其在角膜斜视中的相关性;并确定其在尼泊尔人群中检测亚临床圆锥角膜的诊断能力。方法:选取48例圆锥角膜患者的96只眼和50例对照者的50只正常眼进行研究。将圆锥角膜患者的眼睛分为亚临床、1期、2期和晚期圆锥角膜四个不同的研究组。使用Sirius角膜层析仪测量每只眼的角膜地形图、厚度测量和角膜像差测量指标。将角膜畸变眼的研究参数与正常眼进行比较,探讨角膜像差测量与地形和厚视测量指标之间的关系。同时,对检测亚临床圆锥角膜的各项指标确定受试者工作特征曲线下面积(AUC)及最佳灵敏度和特异性的最佳截止值。结果:亚临床圆锥角膜患者除平均角膜测量值(Kavg、mmavg)和球差(SA)外,其余指标均与对照组比较差异有统计学意义(p min)。除Kavg、mmavg和SA外,其余指标对亚临床圆锥角膜的诊断能力均较好(AUC > 0.90)。提出的角膜后表面不对称指数(SIb)、Strehl点扩散函数比(PSF)、coma和Baiocchi-Calossi-Versaci指数(BCVb)的截止值均具有良好的灵敏度(100%)和特异性(≥97%)。结论:与健康对照相比,亚临床圆锥角膜患者的角膜高阶畸变明显升高。SIb、PSF、coma和BCVb是检测亚临床圆锥角膜最有效的Sirius指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of corneal topography, pachymetry and higher order aberrations for detecting subclinical keratoconus.

Purpose: To compare corneal topography, pachymetry and higher order aberrations in keratoconic and normal eyes; to investigate their association in keratoconic eyes; and to determine their diagnostic ability for detecting subclinical keratoconus in a Nepalese population.

Methods: Ninety-six eyes of 48 keratoconus patients and 50 normal eyes of 50 control subjects were included in this study. The eyes of keratoconus patients were classified into four different study groups: subclinical, stage 1, stage 2 and advanced stage keratoconus. In each eye, corneal topography, pachymetry and corneal aberrometry indices were measured using a Sirius corneal tomographer. The study parameters of keratoconic eyes were compared with normal eyes, and the possible association of corneal aberrometry with topography and pachymetry indices was investigated. The area under curve (AUC) of receiver operating characteristic (ROC) curves along with optimal cutoff values with best sensitivity and specificity were also determined for each index to detect subclinical keratoconus.

Results: All the indices except average keratometry measurements (Kavg and mmavg ) and spherical aberration (SA) were found to be significantly different in subclinical keratoconus compared to the control group (p < 0.05). In keratoconic eyes, all corneal aberrations were significantly correlated with the topography and pachymetry indices (range of ρ: -0.25 to 0.96; all p < 0.05) except for trefoil and minimum corneal thickness (Thkmin ). All the indices except Kavg , mmavg and SA showed excellent diagnostic ability (AUC > 0.90) in detecting subclinical keratoconus. The cutoff values proposed for the asymmetry index of the corneal back surface (SIb ), Strehl ratio of point spread function (PSF), coma and Baiocchi-Calossi-Versaci index of corneal back surface (BCVb ) each showed excellent sensitivity (100%) and specificity (≥97%).

Conclusions: Corneal higher order aberrations were found to be significantly elevated in subclinical keratoconus compared to healthy controls. SIb , PSF, coma and BCVb were identified as the most powerful Sirius indices for the detection of subclinical keratoconus.

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