角膜内皮镜OrbscanⅡ眼前节OCT及超声法测量角膜中央及旁中央厚度的比较研究  

Comparative study of central corneal and midperipheral corneal thickness measurement with specular microscopy, Slit-scanning pachymetry, anterior segment optical coherence tomography and ultrasound pachymetry

作　　者：彭海鹰[1] 庞辰久[1] 王应飞[1] 孔众[1] 王丽娅[1] 

机构地区：[1]河南省眼科研究所,河南郑州450003

出　　处：《中国实用眼科杂志》2012年第8期936-940,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的比较TOPCON角膜内皮镜SP-3000P、OrbscanⅡ眼前节分析仪（OrbscanⅡ）、眼前节光学相干断层扫描仪（AS-OCT）以及A型超声法测量近视眼角膜中心和中央旁角膜厚度差异。方法分别采用角膜内皮镜、OrbscanⅡ、眼前节AS—OCT及超声法测量右眼角膜中央角膜厚度，同时采用前三种方法测量距中心3mm上方（12点），下方（6点），鼻上（2点），颞上（10点）四个位置旁中央角膜厚度。结果134只眼中央角膜厚度测量结果A超最厚为（543．10±32．69）μm，AS-OCT为（537．02±32．39）μm，OrbsanⅡ为（534．93±34．25）μm，角膜内皮显微镜最薄为（515．49±32．76）μm，差异有统计学意义。组间配对t检验AS—OCT与OrbsanⅡ之间的差异没有统计学意义（P=0．07）。一致性分析显示超声与AS—OCT的一致性最好，最大绝对差值为25．43μm。125只眼旁中央角膜厚度测量结果OrbsanⅡ在四个不同位置测量值最大，角膜内皮显微镜测量值最小。结论TOPOCONSP-3000P非接触内皮镜测量中央及中周边角膜厚度较OrbscanⅡ、AS—OCT及超声测量结果明显薄，临床上不能代替其他方法；OrbscanⅡ与AS—OCT测量角膜中央厚度一致性好，可相互替代，但对周边角膜厚度测量差异明显，不可替代使用。Objective To compare corneal thickness （CT） measurements obtained by specular microscopy, Slit-scanning pachymetry, anterior segment optical coherence tomography （AS-OCT） and ultrasound pachymetry, with a focus on central and midpeipheral （3.0 mm） region of cornea. Methods Central CT and CT at four midperipheral points were measured with the specular microscopy （Topcon SP-3000P）, Slit-scanning pachymetry （Orbscan）, AS-OCT and ultrasound pachymetry. Resuits In 134 eyes of 134 healthy subjects, the mean central CT was 543.10±32.69μm for ultrasound pachymetry, 537.02±32.39 μm for AS-OCT, 534.93±34.25μm for Orbsan Ⅱ and 515.49±32.76μm for specular microscopy. No significant difference was found between AS-OCT measurements and Orbsan Ⅱ （P =0.07）. The best agreement was observed in the ultrasound pachymetry and AS-OCT. In 125 eyes, the measurements of mean midperipheral CT obtained by Orbsan Ⅱ were much higher than AS-OCT and specular microscopy at all points. Conclusions Specular microscopy measurements of central CT and midperipheral CT are much thinner than other methods. Central CT measurements obtained by Orbscan Ⅱ and AS-OCT show good agreement, therefore can be used interchangeably; but midperipheral CT measurements cannot be used interchangeably due to the large difference.

关 键 词：角膜厚度 角膜内皮显微镜 前节OCT OrbsanⅡ A型超声 

分 类 号：R778[医药卫生—眼科]