Pentacam与Visante重复性和一致性研OCT测量角膜厚度的究  

Repeatability and agreement of corneal thickness measurement with Pentacam Scheimpflug photography and Visante optical coherence tomography

作　　者：黄锦海[1] 葛利娜 温岱宗 陈世豪[1] 余野[1] 王勤美[1] 

机构地区：[1]温州医学院附属眼视光医院,325027 [2]温州市第二医院 [3]解放军第一八〇医院

出　　处：《中华眼科杂志》2013年第3期250-256,共7页Chinese Journal of Ophthalmology

基　　金：卫生行业科研专项项目（200802114）;浙江省医药卫生科技计划项目（2012KYBl35）;浙江省教育厅科研项目（Y201223147）;温州市科技局资助项目（Y20110045）

摘　　要：目的分析Pentacam眼前节综合分析系统与Visante前节相干光断层扫描仪（OCT）测量近视和准分子激光原位角膜磨镶术（LASIK）后患者中央和周边角膜厚度的重复性、差异性及一致性。方法选取近视与LASIK术后患者各60例（60只眼），分别应用Pentacam（高分辨率版本）和VisanteOCT对角膜中央，最薄点，上、下、鼻、颞距中央半径1．0和2．5mm处厚度，以及角膜最薄点位置进行测量。两种设备的重复性通过组内相关系数、克隆巴赫系数（CoA）和变异系数（CoV）进行比较，两种设备对同一类人群3次测量结果的比较采用配对t检验、Pearson相关分析和Bland—Ahman比较。结果Pentaeam和VisanteOCT测量近视及LASIK术后患者角膜厚度具有高度的重复性，所有的组内相关系数和CoA均〉0．9，CoV〈0．9％。Pentacam测量近视眼患者的角膜中央CoV为0．46±0．30，最薄点为0．43±0．28，均大于VisanteOCT的测量值（t=2．465，2．226；P〈0．05）；距角膜中央顶点4个方向1．0mm处的CoV亦大于VisanteOCT；而两种仪器距角膜中央顶点4个方向2．5mm处的CoV差异均无统计学意义（t=-0．518，1．542，-0．876，0．756；P〉0．05）。Pentacam测量近视眼患者的角膜中央厚度为（543．01±22．89）μm，最薄点为（540．61±22．84）μm，均大于VisanteOCT的测量值（t=17．946，23．071；P〈0．05）；距角膜中央顶点4个方向1．0及2．5Him处的角膜厚度亦大于VisanteOCT。两种仪器测量角膜各位置厚度结果之间差异具有密切的线性相关（r值均〉0．9，P〈0．01）。Bland-Ahman分析角膜最薄点坐标位置测量结果显示，两种仪器测量角膜中央、最薄点及距离中央1．0mm区域的角膜厚度的95％一致性区间（LoA）的范围小于22p,m，而距离中央2．5mm区域的95％LOA变异较大，范围从24txm增加到44um。结论Pentacam和VisanteOCT测量年轻的近视和LASIK术后患者角膜厚Objective To evaluate the repeatability and agreement of central and peripheral corneal thickness （CT）measurements by high resolution Pentacam rotating Scheimpflug photography and Visante optical coherence tomography （OCT） in unoperated myopic eyes and eyes after Laser In Situ Keratomileusis （LASIK）. Methods CT at central, thinnest, 1.0 mm and 2. 5 mm superior, inferior, nasal and temporal periphery locations, and the location of the corneal thinnest thickness were measured using Pcntacam and Visante OCT in 60 myopia patients （60 eyes ） and 60 patients （60 eyes ） after LASIK. The reruhs were analyzed by paired- t test, Pearson correlation analysis and Bland-Altman method. Results Both Pentacamand Visante OCT demonstrated high intraobserver repeatability, with all intraclass correlation coefficients and Cronbaeh＇s alphas were more than 0.9, and coefficient of variation were less than 0.9% . Significantly higher CoV was measured with Pentacam than by Visante OCT in at central（0. 46±0. 30）, thinnest（0. 43±0. 28 ） and 1.0 mm locations in both groups （ t = 2. 465,2. 226, P 〈 0. 05 ）, but no statistically significant difference were found at 2.5 mm locations in healthy subjects and all locations in post-LASIK eyes （ t = - 0. 518,1. 542, -0. 876,0. 756,P 〉 0. 05 ）. The thiekness of central corneal with Pentacam was （543.01 ±22. 89 ） μm, the thinnest point was （ 540. 61 ±22. 84 ） μm, they were greater than the value of Visante OCT （t = 17. 946,23. 071, P 〈0. 05）. The Pearson correlation coefficients were all more than 0. 9 （all r 〉 0. 9, P 〈 0. 01 ）. The Bland-Ahman plots showed the 95% LoA between both devices were lower than 22 μm at central, thinnest and 1.0 mm locations. However, the 95% LoA were 24 μm to 44 μm at 2.5 mm locations. Conclusions Pentacam and Visante OCT demonstrate high repeatability for central and peripheral CT measurements in young myopia and post-LASIK eyes. However, both devices can＇t he used interchangeably for measurement

关 键 词：近视 角膜磨镶术 激光原位 手术后期间 角膜 角膜地形图 体层摄影 术 光学相干 可重复性 结果 

分 类 号：R779.63[医药卫生—眼科]