可视化角膜生物力学分析仪评估青光眼患者角膜生物力学特征  

Assessment of corneal biomechanical properties in glaucoma patients with corneal visualization Scheimpflug technology

作　　者：田磊[1] 吴莹[2] 黄一飞[2] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所眼科学与视觉科学北京市重点实验室,100005 [2]北京解放军总医院眼科解放军军医学院,100853

出　　处：《眼科》2016年第1期30-35,共6页Ophthalmology in China

基　　金：国家自然科学基金(81271052);首都医科大学附属北京同仁医院科研种子基金(2015-YJJ-ZZL-008)

摘　　要：目的评估可视化角膜生物力学分析仪(Corvis ST)测量不同类型青光眼患者角膜的生物力学特征。设计前瞻性病例对照研究。研究对象分别选取正常角膜志愿者,原发性开角型青光眼患者(POAG)和原发性闭角型青光眼患者(PACG)各34例34眼。方法所有入选者均完成眼科系统性相关检查,并应用Corvis ST测量角膜生物力学特征。对比正常志愿者角膜与青光眼患者角膜生物力学特征的区别,分析最大压陷深度(DA)与年龄、眼球形态参数和眼压的相关性。主要指标角膜生物力学参数、眼压、中央角膜厚度(CCT)、角膜体积(CV)。结果 Corvis ST测得正常角膜生物力学参数与青光眼患者组相比,第一和第二压平速度较快,第二压平时间较长,最大压陷屈膝峰间距较大。正常角膜组、POAG和PACG组的DA分别为(1.07±0.10)、(0.97±0.14)和(0.98±0.12)mm(F=7.11,P=0.001),但POAG组和PACG组之间无明显差异。协方差分析调整年龄、眼压、CCT和CV后,三组间DA仍存在明显差异(F=40.989,P<0.001)。三组中DA与眼压均呈明显负相关性。结论 Corvis ST能有效测量正常角膜和不同类型青光眼患者角膜生物力学特征,且多数角膜生物力学参数在三组间存在显著性差异。青光眼患者组角膜受力后较正常角膜形变幅度小,但POAG与PACG组角膜形变幅度相近。DA与眼压呈明显负相关性。Objective To assess the biomechanical properties of cornea in eyes with different types of glaucoma using Corvis ST. Design A prospective case control study. Participants The subjects included normal cornea volunteers and patients with primary openangle glaucoma （POAG） and primary angle-closure glaucoma （PAGC）. Each group included 34 eyes from 34 people. Methods All subjects completed the systematic ophthalmology examination, and the corneal biomechanical measurement using Corvis ST. Comparison the differences of corneal biomechanieal properties between normal eyes and eyes with POAG or PACG. The correlation relationship between deformation amplitude （DA） and age, ocular characteristics and intraocular pressure （IOP） were analyzed also. Main Outcome Measures Corneal biomechanieal parameters, IOP, central corneal thickness （CCT） and corneal volmne （CV）. Results The normal eyes showed faster first and second applanation velocities, greater second applanation time and highest concavity peak distance in normal eyes than glaueomatous eyes. The mean value of DA was （1.07±0.10） mm in normal group, and there were （0.97±0.14） mm and （0.98±0.12） mm in POAG and PACG group, respectively. There was significant difference among the three groups （F=7.11, P=0.001）, but not in POAG and PACG group. After adjusting for age, IOP, CCT and CV, DA still existed obvious difference among groups （F=40.989, P〈0.001）. DA and IOP showed significantly negative correlation in all three groups. Conclusion Corvis ST offers an effectively method for measuring corneal biomeehanical properties. Several parameters exhibited significant differences between glaueomatous eyes and normal eyes. Compared with the normal cornea, the deformation of glaueomatous cornea was smaller, but the deformation of POAG was similar to that of the PACG. DA was obviously affected by IOP with negative correlative relationship.

关 键 词：角膜生物力学 可视化角膜生物力学分析仪 青光眼 最大压陷深度 

分 类 号：R775[医药卫生—眼科]