圆锥角膜患者角膜光密度的临床价值分析  

The Analysis of Clinical Value of Corneal Optical Density in Keratoconus

作　　者：薛雅珺 陈琳 田恬 蔡博 马丽梅[3] 李帅 秦艺璇 庄文娟[2] XUE Yajun;CHEN Lin;TIAN Tian;CAI Bo;MA Limei;LI Shuai;QIN Yixuan;ZHUANG Wenjuan(Medicine College of Northwest University for Nationalities,Yinchuan 750001,China;Department of Ophthalmology,Ningxia Eye Hospital,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750001,China;The Third Clinical Medicine College,Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]西北民族大学医学院,银川750001 [2]宁夏回族自治区人民医院宁夏眼科医院,银川750001 [3]宁夏医科大学第三临床医学院,银川750001

出　　处：《宁夏医科大学学报》2022年第10期1009-1013,共5页Journal of Ningxia Medical University

基　　金：2019年宁夏回族自治区科技攻关项目(2019BEG03016)。

摘　　要：目的探讨角膜光密度对圆锥角膜的诊断价值。方法回顾性研究正常对照组89例(89眼)和圆锥角膜组68例(130眼)患者临床资料,采用Pentacam眼前节分析系统以角膜顶点为中心分别测量0~2 mm、2~6 mm、6~10 mm、0~12 mm直径范围的前层(120μm)、后层(60μm)、中间层以及总层的角膜光密度值。两组间角膜光密度值差异比较采用协方差分析,应用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价角膜光密度对圆锥角膜的诊断价值。结果除6~10 mm直径范围的各层角膜光密度值两组间差异均无统计学意义(P均>0.05)外,在其余不同直径范围内的各层中,尤其是0~2 mm和2~6 mm直径范围各层中,圆锥角膜的光密度值均高于对照组(P均<0.05)。利用不同直径范围内的各层角膜光密度值作为诊断指标绘制ROC曲线,计算曲线下面积得出0~2 mm直径范围的前层、中层和全层大于2~6 mm直径范围内的各层,且AUC均>0.6,差异均有统计学意义(P均<0.05),其中前层0~2 mm直径范围ROC曲线下面积最大,AUC为0.849,截断值为15.550,灵敏度为75.4%,特异度为84.3%,95%置信区间为0.799~0.889(P<0.001),诊断效能最优。结论相比正常人群,圆锥角膜患者的中央区各层角膜光密度值更高,即角膜透明度更低,且中央区前层角膜光密度值的增高可能对早期圆锥角膜具有一定的诊断价值。Objective To investigate the diagnostic value of corneal densitometry for keratoconus.Methods A total of 89 cases(89 eyes)in the control group and 68 cases(130 eyes)in the keratoconus group were included by retrospective research.Pentacam analysis system was used to measure the corneal densitometry value of anterior layer(up to 120μm),posterior layer(posterior 60μm),middle layer(between the anterior and posterior)and the total layer as well as the diameters of 0-2 mm,2-6 mm,6-10 mm,and 0-12 mm with the corneal apex as the center.The difference of corneal densitometry between the two groups was compared by covariance analysis,and receiver operating characteristic(ROC)curve and area under the curve(AUC)were performed to evaluate the diagnostic value of corneal densitometry for keratoconus.Results Except that the optical density of each layer of cornea in the diameter range of 6-10 mm,the other optical density layer showed no statistically different in the two groups(P all>0.05),the rest of each layers in different diameters,especially 0-2 mm and 2-6 mm was higher than that of the control group(P all<0.05).The optical density values of each layer of cornea in different diameter ranges are used as diagnostic indicators to draw ROC curves,it demonstrated that the AUC was larger in the diameter of 0-2 mm including the anterior layer,middle layer and total layer than that of 2-6 mm in each layer,and the AUC Both were beyond 0.6 as well as the difference was statistically significant(P all<0.05).The area under the ROC curve in the range of 0-2 mm diameter of the anterior layer is the largest,AUC was 0.849,cut-off value was 15.55,sensitivity was 75.4%,specificity was 84.3%and the 95%confidence interval was 0.799-0.889(P<0.001),and the diagnostic efficiency was the best.Conclusion Compared with normal population,the optical density of each layer of the cornea in the central area of keratoconus is higher,the corneal transparency is lower.Meanwhile,the increase of densitometry in the anterior cornea of central zone could h

关 键 词：角膜光密度 圆锥角膜 眼疾病 

分 类 号：R779.6[医药卫生—眼科]