| 傅立叶OCT角膜厚度参数在临床前期圆锥角膜筛查中的作用 |
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| 引用本文： | 朱晓博 周跃华. 傅立叶OCT角膜厚度参数在临床前期圆锥角膜筛查中的作用[J]. 眼科, 2013, 22(3): 165-169 |
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| 作者姓名： | 朱晓博 周跃华 |
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| 作者单位： | 100730.首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室 |
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| 摘 要： | 目的 探讨傅立叶OCT（RTVueOCT）角膜厚度参数在临床前期圆锥角膜筛查中的作用。设计 诊断技术评价。研究对象 北京同仁医院屈光中心就诊的临床期圆锥角膜患者36例（56眼）；临床前期圆锥角膜患者38例（57眼）；正常对照组30例（60眼）。方法 采用裂隙灯显微镜及Tomey角膜地形图进行检查。可疑圆锥角膜者，经3~6个月随访角膜地形图KSI值增大或局部曲率较前增高，诊断为临床前期圆锥角膜。采用RTVueOCT测量圆锥角膜组，临床前期圆锥角膜组患眼及正常对照组双眼的角膜厚度参数，包括上方与下方角膜平均厚度的差值（S-I值）、鼻上方与颞下方角膜平均厚度的差值（SN-IT值）、最小角膜厚度值（MIN）、最小与中间值角膜厚度差（MIN-MED）、最小与最大角膜厚度差（MIN-MAX）、最薄点X-location和最薄点Y-location。比较三组间参数差异，取差异有统计学意义的参数，绘制ROC曲线，计算各参数区分正常对照组和临床期圆锥角膜、临床前期圆锥角膜的切点、敏感度和特异度。主要指标 S-I值、SN-IT值、MIN、MIN-MED、MIN-MAX、最薄点X-location和最薄点Y-location、ROC曲线下面积、敏感度及特异度。结果 与正常对照组相比，临床前期圆锥角膜组及临床期圆锥角膜组的IT-SN、 I-S 、MIN、MIN-MED、MIN-MAX值均明显增加，且呈递增趋势（P均<0.05）。上述各参数在区分临床前期圆锥角膜和正常对照组时的ROC曲线下面积分别为0.757、0.732、0.858、0.769、0.790；切点分别为-28.5、 -33.5、 487.0、 -22.5、 -53.0 μm；其敏感性分别为0.632、0.404、0.667、0.596、0.632；特异度分别为0.833、0.967、0.900、0.937、0.917。结论 RTVueOCT角膜厚度参数能有效地筛查临床前期圆锥角膜。
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| 关 键 词： | RTVueOCT 角膜厚度 角膜地形图 圆锥角膜/诊断 |
| 收稿时间： | 2013-02-18 |
The role of the parameters measured with RTVueOCT in the screening of subclinical keratoconus |
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| ZHU Xiao-bo,ZHOU Yue-hua. The role of the parameters measured with RTVueOCT in the screening of subclinical keratoconus[J]. Ophthalmology in China, 2013, 22(3): 165-169 |
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| Authors: | ZHU Xiao-bo ZHOU Yue-hua |
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| Affiliation: | Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China |
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| Abstract: | Objective To estimate the role of the pachymetry paramerers measured with high-speed anterior segment optical coherence tomography (RTVueOCT) in the screening of subclinical keratoconus. Design Evaluation of diagnosis technique. Participants Thirty-six cases (56 eyes) with keratoconic, 37 cases (57 eyes) with subclinical keratoconic, and 30 normal subjects (60 eyes) were enrolled. Method Kertoconus or suspected keratoconus were diagnosed based on the examinations with the slit lamp microscope and Tomey corneal topographic map. If the results of the two exams suggested to be suspect, the eyes whose KSI value and local curvature increased after the following up for 3~6 months were diagnosed as subclinical keratoconus. The pachymetry paramerers were measured by RTVueOCT and compared among the normal eyes, subclinical kertoconus group, and the kertoconus group. The parameters included superior-inferior (S-I), superonasal-inferotemporal (SN-IT), minimum(MIN), minimum-median(MIN-MED), minimum-maximum(MIN-MAX), and the location of the thinnest cornea (X-location,Y-location). Receiver operating characteristic (ROC) curves were used to analyzed the optimal cutoff points, sensitivity, and specificity of the pachymetry pamameters to differentiate the keratoconic eyes, or subclinical keratoconus eyes from the normal eyes. Main Outcome Measures S-I, SN-IT, MIN, MIN-MED, MIN-MAX, X-location, Y-location, area under the ROC curve (AROC), sensitivity, and specificity. Results IT-SN, I-S, MIN, MIN-MED, and MIN-MAX in the subclinical keratoconus group and keratoconic group were significantly increased than in the control group, and which were significantly increased in keratoconic group than in the subclinical keratoconus group (all P<0.05). To differentiate the subclinical keratoconic eyes from the normal eyes, the AROC of the IT-SN, I-S, MIN, MIN-MED, and MIN-MAX was 0.757, 0.732, 0.858, 0.769, and 0.790, respectively; the cutoff point was -28.5, -33.5, 487.0, -22.5, and -53.0 μm, respectively; the sensitivity was 0.632， 0.404， 0.667， 0.596 and 0.632; the specificity was 0.833， 0.967， 0.900， 0.937 and 0.917, respectively. Conclusion RTVueOCT can play an important role in the screening of the subclinical keratoconus. |
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| Keywords: | RTVueOCT pachymetric parameters corneal topography keratoconus/diagnosis |
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