全景角膜扫描显微镜与非接触式角膜内皮镜测量角膜内皮参数的比较  

Comparison of Endothelial Cell Measurements by Slit-Scanning Wide-Field Contact Specular Microscopy and Noncontact Specular Microscopy

作　　者：王海鸥 沈煜 陈豪 刘卫斯 郑钦象 陈蔚 Haiou Wan;Yu Shen;Hao Chen;Weisi Liu;Qinxiang Zheng;Wei Chen(Eye Hospital of Ophthalmology and Optometry,Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属眼视光医院,温州325027

出　　处：《中华眼视光学与视觉科学杂志》2023年第3期201-206,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:评估全景角膜扫描显微镜(CellChek C)测量角膜内皮细胞参数的重复性和再现性,并比较其与非接触式角膜内皮镜(SP3000)的一致性。方法:横断面研究。连续性纳入2021年5月至2022年5月在温州医科大学附属眼视光医院进行健康检查的健康受检者50例,其中男38例,女12例,年龄19~79(50.7±20.2)岁。由2名操作者分别应用CellChek C和SP3000测量受检者的角膜内皮细胞密度(ECD)、六边形细胞百分比(HEX)、平均细胞面积(ACS)、变异系数(CV)。采用组内标准差(Sw)、重测系数(TRT)、组内变异系数(CoV)、组内相关系数(ICC)来评估测量两种仪器的重复性和CellChek C的再现性,B1and-Altman法分析2种仪器的一致性。结果:CellChek C测得的单幅测量细胞个数为(559.9±56.5)个,显著大于Topcon-sp3000所测得的(94.7±21.3)个(P<0.001)。2种仪器在测量ECD的TRT分别为161.28个/mm^(2)和173.72个/mm^(2),CoV分别为2.17%和2.42%,ICC值均大于0.9,具有良好的重复性。2种仪器在测量ACS亦具有较好的重复性,TRT分别为22.23μm^(2)和30.94μm^(2),CoV分别为2.13%、2.86%,ICC值为0.928、0.922。CellChek C的HEX和CV的ICC值均介于0.75~0.9,而SP3000对于六边形细胞百分比的测量重复性较差(ICC=0.528)。CellChek C测得的ECD、HEX、ACS和CV具有较好的再现性,其ICC分别为0.946、0.914、0.940和0.842。2种仪器测量ECD(P=0.004)、HEX(P<0.001)、ACS(P=0.014)和CV(P<0.001)差异存在统计学意义,并且其95%一致性区间(LoA)均较大,分别为-293.3~458.5个/mm^(2),-23.5%~6.4%,-42.3~8.6μm^(2)以及0.7~27.8。结论:CellChek C在测量健康成人角膜内皮细胞参数时具有良好的重复性和再现性,其与SP3000的一致性较差。Objective:To evaluate the repeatability and reproducibility of corneal endothelium cells measured by slitscanning wide-field contact specular microscopy(CellChek C),and to examine its the agreement with a noncontact specular microscopy(SP3000).Methods:This was a cross-sectional study.A total of 50 healthy subjects,including 38 males and 12 females,aged 50.7±20.2 years(ranging 19-79 years),who underwent health examination in the Eye Hospital of Ophthalmology and Optometry Wenzhou Medical University from May 2021 to May 2022,were consecutively selected.All subjects were examined by two examiners with CellChek C and SP3000 for corneal endothelial cell density(ECD),average cell size(ACS),the percentage of hexagonal shape cells(HEX),coefficient of variation(CV).Within-subject standard deviation(Sw),test-retest repeatability(TRT),the within-subject coefficient of variation(CoV)and the intra-class correlation coefficient(ICC)were used to analyze reproducibility.Bland-Ahman was used to assess the agreement of the instruments.Results:The number of the cells used to analyze with CellChek C was significantly larger than SP3000(559.9±56.5 cells vs.94.7±21.3 cells,P<0.001).The repeatability results of ECD and ACS measured by CellChek C and SP3000 were good.The TRT values and CoV values of ECD measured by the two instruments were 161.28 cells/mm^(2) and 173.72 cells/mm^(2),2.17%and 2.42%,respectively,with good repeatability.The TRT values and CoV values of ACS were also with good repeatability,with result of 22.23μm^(2) and 30.94μm^(2),2.13%and 2.86%,respectively.The ICC were 0.928 and 0.922.The ICC of the percentage of HEX and CV measured by CellChek C are between 0.75 to 0.9.However,the repeatability of SP3000 for the HEX was poor(ICC=0.528).The reproducibility of ECD,HEX,ACS,CV measured by CellChek C were good.The ICC were 0.946,0.914,0.940 and 0.842,respectively.There were significant differences in the results of ECD(P=0.004),HEX(P<0.001),ACS(P=0.014)and CV(P<0.001)between the two instruments.The 95%LoA of ECD,HEX,AC

关 键 词：角膜内皮显微镜 角膜内皮细胞 重复性 再现性 一致性 

分 类 号：R770.4[医药卫生—眼科]