RTVue傅里叶OCT测量泪新月参数的重复性和再现性评价

背景 光学相干断层扫描（OCT）测量泪新月参数在干眼诊断、疗效评估和随访中具有较好的辅助作用.目前RTVue傅里叶OCT（FD-OCT）已被用于泪新月参数的测量,但相关测量的重复性和再现性研究鲜有报道. 目的 研究RTVue FD-OCT测量泪新月参数的重复性和再现性,为干眼诊断、治疗效果评价和随访提供参考依据.方法 本研究属于前瞻性研究.经干眼常规诊断检查后,在受试者中分别纳入干眼组和正常对照组各20例,共40例40眼.操作熟练的两位检查者使用RTVue FD-OCT采集所有受试者的上下泪新月图像.随机选择每位受试者的一眼,先由一位检查者连续拍摄3次,每次间隔2～3 min;休息10～15 min后,另一检查者以同样方式拍摄3次.通过测量软件获得上泪新月曲率（UMC）、上泪新月高度（UMH）、上泪新月面积（UMA）、下泪新月曲率（LMC）、下泪新月高度（LMH）和下泪新月面积（LMA）,采用平均重复系数（MCOR）评估同一操作者3次连续测量的重复性;采用重复系数（COR）及组内相关系数（ICC）评估两位操作者测量的再现性. 结果 正常对照组的UMH、UMA、LMH和LMA的MCOR分别为5.11％、3.58％、4.98％和4.82％,干眼组UMH、UMA、LMH和LMA的MCOR分别为5.60％、5.80％、5.03％和5.74％.正常对照组和干眼组中,除干眼组UMC、LMC的MCOR分别为11.10％和10.72％外,其余参数MCOR均＜10％.正常对照组UMA的COR和ICC分别为5.38％和0.975,LMA的COR和ICC分别为5.28％和0.961;干眼组LMA的COR和ICC分别为9.69％和0.964.两组中除了泪新月曲率（TMC）外,其余参数的ICC均＞0.75.除正常对照组的UMC和干眼组的UMC、UMA、LMC外,其余参数的COR均＜10％. 结论 RTvue FD-OCT测量泪新月,UMA、LMH和LMA参数图像间重复性较好,LMA参数操作者间再现性良好.RTVue FD-OCT泪新月图像TMH和TMA参数,尤其是LMH和LMA在于眼诊断中具有重要的临床应用价值.

Repeatability and reproducibility of tear meniscus parameters measured by RTVue Fourier-domain optical coherence tomography

Background Tear meniscus gained by OCT device is essential to the dry eye diagnosis.Currently,RTVue Fourier-domain optical coherence tomography （FD-OCT） is commercially available to image the tear menisci.However,there were few studies to report the repeatability and reproducibility of lower and upper tear meniscus parameters measured by RTVue FD-OCT.Objective The purpose of this study was to assess the repeatability and reproducibility of lower and upper tear meniscus parameters measured by RTVue FD-OCT in normal and dry eyes.Methods In this prospective study,20 dry eyes of 20 patients were finally recruited,and 20 normal eyes of 20 age-and gender-matched healthy subjects were included during the same period.Successive three-time scans were performed at a 3-minute interval with RTVue FD-OCT in optional eye by one well-trained examiner,and the other operator performed the same measurement 10-15 minutes later.Six parameters of tear meniscus were yielded by custom software,including upper meniscus curvature （UMC）,upper meniscus height（UMH）,upper meniscus area （UMA）,lower meniscus curvature （LMC）,lower meniscus height （LMH） and lower meniscus area （LMA）.The between-image repeatability was assessed using mean coefficient of repeatability （MCOR）,while between-operator reproducibility were evaluated using coefficient of repeatability （COR） and interclass correlation of coefficients （ICC）.Results As for the between-image repeatability,the results of MCOR for UMH,UMA,LMH and LMA were 5.11％,3.58％,4.98％ and 4.82％ respectively in the normal eyes and 5.60％,5.80％,5.03％ and 5.74％ respectively in the dry eyes.As for the between-operator reproducibility,the results of COR and ICC for UMA were 5.38％ and O.975,the COR and ICC for LMA were 5.28％ and 0.961 respectively in the normal eyes,and the results of COR and ICC for LMA were 9.69％ and 0.964 in the dry eyes.Conclusions The UMA,LMH and LMA tear meniscus parameters obtained by RTvue FD-OCT show good between-image repea