PASCAL动态轮廓眼压计临床应用的初步报告

目的:验证动态轮廓眼压计(DCT)的临床性能。方法:对81例143眼青光眼及可疑病例青光眼患者用DCT测量眼内压(IOP);132眼同时用Goldmann压平眼压计(GAT)测量眼压,部分病例同时用NIDEKUP-1000型角膜测厚仪测量中央角膜厚度(CCT)。GAT与DCT测量结果采用配对t检验,GAT、DCT测量值与CCT的关系及DCT测量值与眼脉动振幅(OPA)的相关关系采用Spearman双变量相关分析。结果:①DCT和GAT测得的眼压均数分别为(18.6±3.9)mmHg和(17.4±4.1)mmHg;DCT测得的眼压值高于GAT,其差值均数为(1.1±2.3)mmHg;两种眼压计测得的眼压值呈正相关(r=0.83,P<0.01)。②116眼同时完成了DCT眼压测量及CCT测量,两者相关系数r=0.03,P=0.77;113眼同时完成了GAT眼压测量及CCT测量,两者相关系数r=0.28,P=0.003。③143眼同时记录了DCT眼压值和眼脉动振幅(OPA),其均数分别为(18.6±3.9)mmHg和(2.6±1.1)mmHg,两者的相关系数r=0.32,P<0.01。结论:以上结果初步证实:①DCT眼压计测量值与GAT眼压测量值高度相关,但DCT测量值略高于GAT测量值,提示DCT可用于临床诊断。②DCT测量值与CCT不相关,GAT测量值与CCT显著相关,提示DCT在青光眼诊断中有独特优势。③DCT测量的OPA与IOP值显著相关,相关的机制及临床意义有待探讨。

Preliminary report on use of dynamic contour tonometer in clinic

AIM:To validate the clinical natures of dynamic contour tonometer(DCT).· METHODS:Intraocular pressure(IOP)obtained by DCT on 143 eyes of 81 patients who were diagnosed glaucoma or suspected glaucoma;132 eyes had a measurement of IOP by Goldmann Applanation Tonometer(GAT)simul-taneously.Otherwise,central cornea thickness(CCT)was measured by NIEDK UP-1000 on some eyes.The IOP measurements of DCT and GAT were compared by paired-samples t-test.The relationship of DCT-CCT,GAT-CCT and DCT-OPA(ocular pulse amplitude)adopted the Spearman bivariate analysis.· RESULTS:There was a positive correlation between the IOP readings obtained by DCT and GAT(r=0.83,P<0.01).However,IOP readings were consistently higher with DCT than those with GAT(mean difference:1.1±2.3 mmHg).116 eyes underwent DCT and CCT measurements(r=0.03,P=0.77)while 113 eyes underwent GAT and CCT measurements simultaneously(r=0.28,P=0.003).The ocular pulse amplitude(OPA)readings had a significant correlation with IOP readings by DCT(r=0.32,P<0.01).· CONCLUSION:IOP measurements by DCT are highly correlated with IOP readings obtained from GAT but have no correlation with CCT.DCT has unique advantages in the diagnosis of glaucoma and DCT seems to be an appropriate method of tonometry for routine clinical use.