眼科 ›› 2013, Vol. 22 ›› Issue (2): 110-116.

• 论著 • 上一篇    下一篇

Pentacam系统检测角膜曲率和高度在圆锥角膜早期诊断中的应用

 张雪,  胡琦,  康杨,  李雪,  周文艳,  王珂萌   

  1. 150001 哈尔滨医科大学附属第一医院眼科视光学中心 
  • 收稿日期:2012-05-16 出版日期:2013-03-25 发布日期:2013-03-26
  • 通讯作者: 胡琦, Email:huqi5115@sina.com
  • 基金资助:

    哈尔滨市科技创新人才研究专项资金项目(2011RFXYS051)

Corneal curvature and elevation for early diagnosis of keratoconus with Pentacam

 ZHANG  Xue,   Hu-Qi,   Kang-Yang,   Li-Xue,   Zhou-Wen-Yan,   Wang-Ke-Meng   

  1. The Center of Optometry, Department of Ophthalmology of the First Affiliated Hospital of Harbin Medical University, Heilongjiang 150001, China
  • Received:2012-05-16 Online:2013-03-25 Published:2013-03-26
  • Contact: HU Qi, Email: huqi5115@sina.com

摘要: 目的  探讨Pentacam眼前节分析系统检测的角膜前后表面曲率和高度参数在临床期圆锥角膜、亚临床期圆锥角膜和正常角膜中的变化以及Pentacam眼前节分析系统在圆锥角膜早期诊断中的意义。设计 诊断技术评价。研究对象 临床期圆锥角膜组患者16例(16眼),亚临床期圆锥角膜组19例(19眼),有近视散光的患者29例(29眼)为正常对照组。方法 应用Pentacam眼前节分析系统检测出临床期圆锥角膜组、亚临床期圆锥角膜组和正常对照组患者的角膜前后表面曲率和高度的12个参数。利用t检验和受试者工作特征曲线(ROC曲线)分析方法对各参数进行比较研究,利用偏最小二乘(PLS)方法构建临床期圆锥角膜和亚临床期圆锥角膜的早期诊断模型。 主要指标 角膜前后表面曲率和高度参数。结果 角膜前后表面曲率和高度参数在临床期圆锥角膜组、亚临床期圆锥角膜组与正常对照组之间存在差异(P均<0.001)。ROC曲线分析结果显示临床期圆锥角膜组、亚临床期圆锥角膜组中各参数的曲线下面积(AUC)均接近于1,说明其诊断准确性较高,并且分别得出在临床期圆锥角膜和亚临床期圆锥角膜中较好参数的诊断界值:角膜前表面5 mm内在最佳配适球镜(BFS)上的最大高度(MaxAE5)为13.5 μm和10 μm,角膜后表面5 mm内在BFS上的最大高度(MaxPE5)为34.5 μm和24.5 μm。应用PLS方法构建了临床期和亚临床期圆锥角膜的早期诊断模型。结论Pentacam眼前节分析系统检测的角膜前后表面曲率和高度参数对临床期圆锥角膜和亚临床期圆锥角膜的早期诊断有重要意义。(眼科, 2013,22: 110-115)

关键词: 圆锥角膜, Pentacam, 角膜曲率

Abstract: Objective To investigate the change of anterior and posterior corneal curvature and corneal elevation parameters with Pentacam in discriminating between clinical keratoconus eyes, subclinical keratoconus eyes and normal eyes. Design Evaluation of diagnostic technology. Participants Sixteen patients (16 eyes) with clinical keratoconus, 19 patients (19 eyes) with subclinical keratoconus, and 29 patients (29 eyes) with myopic astigmatism as control group were analyzed. Method Twelve anterior and posterior corneal curvature and corneal elevation parameters provided by Pentacam were recorded for all groups. The t test and receiver operating characteristic (ROC) curves were used and partial least squares (PLS) was used to construct models with anterior and posterior corneal curvature and corneal elevation parameters for the early diagnosis of keratoconus. Main Outcome Measures The anterior and posterior corneal curvature and corneal elevation parameters. Results There were significant differences between the clinical keratoconus group, the subclinical keratoconus group and the control group. The values of area under the curve(AUC)were all closed to 1, and the diagnosis accuracy was higher. The optimum cutoff points of maximum anterior corneal elevation above the BFS at central 5.0 mm (MaxAE5) for clinical keratoconus and subclinical keratoconus were 13.5 μm and 10 μm respectively. The maximum posterior corneal elevation above the BFS at central 5.0 mm (MaxPE5) for clinical keratoconus and subclinical keratoconus were 34.5 μm and 24.5 μm. Conclusion The anterior and posterior corneal curvature and corneal elevation parameters obtained with Pentacam might be useful for the early diagnosis of clinical and subclinical keratoconus. (Ophthalmol CHN, 2013, 22: 110-115)

Key words: keratoconus, pentacam, corneal curvature