亚临床圆锥角膜的诊断标准  

A systematic review of diagnostic criteria for subclinical keratoconus

作　　者：蒋晗笑 许叶圣[2] 郑利斌 姚玉峰[2] Jiang Hanxiao;Xu Yesheng;Zheng Libin;Yao Yufeng(Department of Ophthalmology,The Fourth Hospital of Zhejiang University School of Medicine,Yiwu Zhejiang 322000,China;Department of Ophthalmology,Zhejiang Province Key Laboratory of Corneal Disease Research,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310018,China)

机构地区：[1]浙江大学医学院附属第四医院眼科,浙江义乌322000 [2]浙江大学医学院附属邵逸夫医院眼科浙江省角膜病研究重点实验室,杭州310018

出　　处：《国际眼科纵览》2023年第2期97-103,共7页International Review of Ophthalmology

基　　金：国家自然科学基金(U20A20387);浙江省医药卫生科技计划项目(2019ZD040)。

摘　　要：目的确定已发表文章中亚临床圆锥角膜的诊断标准。方法对PubMed、Cochrane图书馆、Embase数据库、中国知网、万方数据库和维普中文科技期刊全文数据库2000年1月至2022年3月的所有使用关键词“亚临床圆锥角膜(subclinical keratoconus)”的研究进行系统性综述。2位研究者分别对纳入的文献进行数据分析。文章纳入标准是分析的亚临床圆锥角膜样本量>20眼;包含亚临床圆锥角膜的诊断标准;采用纽卡斯尔-渥太华量表评估文献质量。对所选文献的诊断标准和使用的检查仪器进行分析。结果初步搜索共收集263项研究,其中207项研究被排除在外。最常使用的亚临床圆锥角膜的诊断标准:对侧眼确诊圆锥角膜(66.07%,37/56);在裂隙灯显微镜下缺乏任何圆锥角膜相关的发现/体征(35.71%,20/56);在裂隙灯显微镜、角膜测量学、视网膜检影镜和直接检眼镜检查中显示正常的角膜(33.93%,19/56)。结论目前缺乏统一的标准来定义亚临床圆锥角膜。最常用的亚临床圆锥角膜诊断标准组合为对侧眼确诊圆锥角膜+裂隙灯显微镜检查显示为正常的角膜。Objective To identify the diagnostic criteria used for the terms subclinical keratoconus in published articles.Methods This was a systematic review of all research on the use of the keyword"subclinical keratoconus"in PubMed,Cochrane Library,Embase database,CNKI,Wanfang Data Knowledge Service Platform and China Science and Technology Journal Database from January 2000 to March 2022.Two independent reviewers analyzed the data.The inclusion criteria for articles included that a sample size of subclinical keratoconus eyes was greater than 20 eyes,they contained the definition of subclinical keratoconus,and Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of literature.Inclusion criteria for definition and examination technology used of the selected articles were then analyzed.Results A total of 263 studies were included,of which 207 were excluded.Definitions for subclinical keratoconus included that the criteria of having keratoconus in the fellow eye was in 66.07%(37 of 56)of the articles.Lacking of any keratoconus-related findings/signs in the slit-lamp biomicroscopy was in 35.71%(20 of 56).Normal-appearing corneal on slit-lamp biomicroscopy,or keratometry,or retinoscopy,or ophthalmoscopy was in 33.93%(19 of 56).Conclusions This review demonstrates the lack of unified criteria to define subclinical keratoconus.According to the literature review,the most common subclinical keratoconus definition used refers to an eye with keratoconus in the fellow eye and normal-appearing corneal on slit-lamp biomicroscopy.

关 键 词：亚临床圆锥角膜 诊断标准 系统性综述 

分 类 号：R772.2[医药卫生—眼科]