国际眼科纵览 ›› 2022, Vol. 46 ›› Issue (1): 60-65.doi: 10.3760/ cma.j.issn.1673-5803.2022.01.012

• 综述 • 上一篇    下一篇

早期圆锥角膜的诊断方法

何曦 李仕明   

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室100730
  • 收稿日期:2021-07-15 出版日期:2022-02-22 发布日期:2022-03-14
  • 通讯作者: 李仕明, Email:lishiming81@163.com E-mail:lishiming81@163.com
  • 基金资助:
    北京市自然科学基金杰出青年科学基金(JQ20029);首都卫生发展科研专项(2020-2-1081);国家自然科学基金(82071000)

Early diagnoses of keratoconus

He Xi, Li Shiming   

  1. Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2021-07-15 Online:2022-02-22 Published:2022-03-14
  • Contact: Li Shiming, Email:lishiming81@163.com E-mail:lishiming81@163.com
  • Supported by:
    Outstanding Youth Science Fund of Beijing Natural Science Foundation (JQ20029);Capital Health development Scientific Research Project (2020-2-1081);National Natural Science Foundation of China (82071000)

摘要: 圆锥角膜是好发于青春期、以角膜突出变薄并向前呈锥形突起为特征的致盲性眼病。进展期圆锥角膜较易通过临床症状及眼前节检查发现,而早期圆锥角膜(包括可疑圆锥角膜、亚临床圆锥角膜、顿挫型圆锥角膜)由于视力下降不明显、角膜改变较轻微,难以通过一般检查发现,目前通常采用角膜地形图进行判断。相干光断层扫描作为另一种角膜形态学检测方法,逐渐受到重视,作为角膜地形图的辅助诊断手段。眼反应分析仪及Corvis ST设备通过测量眼生物力学参数,可发现早于形态学变化的角膜结构改变。以上方法均可得到数量可观的参数,人工智能技术目前已尝试用于探索圆锥角膜参数的变化规律,有助于实现早期诊断。此外,易感基因及生物标志物的发现将有助于筛查高风险人群,提醒定期检查、尽早发现异常并干预。(国际眼科纵览,2022, 46:60-65)

关键词: 圆锥角膜/诊断, Corvis ST生物力学指数, 形态生物力学指数, 上皮层最大扩张指数, 基因诊断

Abstract: Keratoconus is a kind of corneal disease which mostly affect adolescent and could cause blindness, characterized with significant thinning as well as cone-like protruding of cornea. Advanced stage of the disease could be diagnosed by clinical symptoms and examinations of ocular anterior segment easily. However, it is difficult to detect when keratoconus is of early stage, including suspected keratoconus, subclinical keratoconus and forme fruste keratoconus, due to its subtle corneal changes and mild vision loss. Corneal topography is now the most common method being used to diagnose the disease. As another approach to obtain corneal morphology, optical coherence tomography gradually gains more attentions. Ocular reactive analyzer and Corvis ST device could find structure alternations earlier than morphologies by measuring ocular biomechanical parameters. A number of parameters could be obtained by various devices, artificial intelligent technologies has already been used to investigate the regulations of those parameters in diagnosing early keratoconus. Additionally, susceptible genes or biomarkers been investigated would be helpful to differentiate high risk population, reminding them to have ocular examinations regularly in order to find abnormalities as early as possible. (Int Rev Ophthalmol, 2022, 46: 60-65)

Key words: keratoconus/diagnosis, Corvis biomechanical index, tomographic biomechanical index, maximum epithelial ectasia index, genetic diagnosis