圆锥角膜患者角膜地形图形态学特征  

Study of the clinical characteristics of corneal topography in patients with keratoconus

作　　者：隋文婕[1,2] 宋鹏[1,2] 刘明娜[2,3] 李素霞[2,3] 贾艳妮[2,3] 高华[2,3] 

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院山东省眼科研究所,250022 [2]山东省眼科研究所,济南,250021 [3]山东省眼科医院,济南250021

出　　处：《中华眼视光学与视觉科学杂志》2014年第2期106-111,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：山东省自然科学基金，山东省医药卫生科技发展计划，山东泰山学者计划，山东省优秀创新团队“角膜病的临床及应用基础研究”项目

摘　　要：目的观察圆锥角膜患者角膜地形图形态学特征，为临床早期诊断和筛查圆锥角膜及分析网锥角膜发病机制提供依据。方法回顾性病例对照研究。选取临床完成期圆锥角膜患者62例（66眼）、初期圆锥角膜患者57例（57眼）及正常对照者35例（70眼）行三维眼前节分析仪（ALLEGROOculyzer）检查。角膜后表面高度图形态分为岛型、不完全岛型、桥型递增型、桥型递减型、不完全桥型及不规则型6种。分析各组角膜后表面高度图形态学特点及角膜最薄点与顶点及瞳孔中心之间位置关系，数据采用单因素方差分析和非参数秩和检验进行分析。结果正常对照组角膜后表面高度图形态以不完全桥型（6l％）和桥型递减型（26％）为主，初期圆锥角膜组以桥型递增型（40％）和不完全岛型（25％）为主，完成期圆锥角膜组以不完全岛型（33％）和岛型（56％）为主。正常对照组、初期圆锥角膜组、完成期圆锥角膜组角膜最薄点位于顶点颞下方比例分别为81％、86％、76％，最薄点与顶点距离分别为（0.59±0.20）mm、（0.77±0.27）mm、（0.66±0.32）mm，3组比较差异有统计学意义（F=6.903，P〈0.01）；最薄点偏离顶点颞下方角度分别为：（41.96±17.30）°、（49.14±18.83）°、（49.40±16.77）°，3组比较差异有统计学意义（F=3.112，P〈0.05）。结论 可疑圆锥角膜患者角膜后表面由不完全桥型向桥型递增型发展，角膜最薄点偏离顶点距离增加要警惕圆锥角膜的可能。[Abstract] Objective To observe the morphological characteristics of corneal topography in patients with keratoconus using the ALLEGRO Oculyzer for measurements; to provide data for early diagnosis and screening of keratoconus and an analysis of the pathogenesis of keratoconus. Methods This was a retrospective case control study. Sixty-two clinical keratoconus patients （66 eyes）, 57 subclinical keratoconus patients （57 eyes） and 35 healthy people （70 eyes） were enrolled in this research. All of them were examined using the Oculyzer for measurements. Posterior surface topography classifications for elevation were divided into 6 types： island, incomplete island, increasing bridge, decreasing bridge,incomplete bridge and irregular type. The morphological features of the elevation pattern maps and the position of the cornea at the thinnest point were studied by observing the pachometer apex and the pupil center. The collected data were analyzed with one-way ANOVA and a nonparametric test. Results The types of topography of the posterior surface in the normal eyes （group l） were mainly an incomplete bridge （61%） and decreasing bridge （26%）, the topography of the subclinical keratoconus eyes （group 2） were mainly an increasing bridge （40%） and an incomplete island （25%）, and the clinical keratoconus eyes （group 3） were mainly an incomplete island （33%） and island （56%）. The thinnest points were located in the inferior temporal region in 81%, 86%, and 76%, respectively. The distance between the thinnest point and corneal apex in groups 1, 2,

关 键 词：角膜地形图 圆锥角膜 后表面形态 最薄点 

分 类 号：R772.2[医药卫生—眼科]