角膜特征在开角型青光眼患者疾病进展中的评估价值  

Evaluation of corneal features in disease progression in patients with primary open-angle glaucoma

作　　者：张宇 赵庆一 张新月 吴宁玲[2] 蒋荧星 ZHANG Yu;ZHAO Qingyi;ZHANG Xinyue;WU Ningling;JIANG Yingxing(Ophthalmology Department,Zhangjiagang Traditional Chinese Medicine Hospital,Zhangjiagang 215600,China;Eye Hospital of the China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]张家港市中医医院眼科,江苏张家港215600 [2]中国中医科学院眼科医院,北京100040

出　　处：《现代医学》2023年第8期1046-1051,共6页Modern Medical Journal

基　　金：中国中医科学院科技创新工程项目(CI2021 A02612)。

摘　　要：目的:探讨角膜特征在开角型青光眼(POAG)患者疾病进展中的评估价值。方法:选择2020年1月至12月间首次确诊POAG的患者97例(154只眼)作为研究对象。在开始治疗前收集患眼一般资料、角膜特征。对治疗后患者进行为期2年的随访,统计目标眼病情进展情况并进行分组。通过Cox回归分析角膜特征与病情进展之间的相关性,最后通过建立ROC曲线分析评估的价值。结果:进展组患眼行睫状体光凝术占比高于未进展组,差异具有统计学意义(P<0.05)。进展组患眼第一压平时间(A1T)长于未进展组、第二压平时间(A2T)短于未进展组,最大压陷曲率半径(CCR)及第一压平时角膜硬度参数(SP-A1)小于未进展组,差异具有统计学意义(P<0.05)。A1T(HR=2.768)、CCR(HR=7.185)、A2T(HR=0.393)及进行睫状体光凝术(HR=3.246)与POAG病情进展相关(P<0.05)。联合预测的曲线下面积明显高于A1T、A2T、CCR单项检测(Z值分别为4.291、3.593、3.915,均P<0.001)。结论:基于角膜生物力学检测的角膜特征模型对于POAG病情进展的预测具有一定的价值。Objective:To investigate the evaluation value of corneal features in disease progression in patients with primary open-angle glaucoma(POAG).Methods:ALL of 97 patients(154 eyes)who were first diagnosed with POAG from January to December 2020 were selected as the study subjects.General data and corneal characteristics of the affected eye were collected before starting treatment.Then the patients were followed up for 2 years after treatment,and the progress of the target eye disease was counted and grouped.The correlation between corneal characteristics and disease progression was analyzed by Cox regression.Finally,the value of the evaluation was analyzed by establishing ROC curve.Results:The proportion of ciliary body photocoagulation in the advanced group was higher than that in the non-advanced group,the difference was statistically significant(P<0.05).The first applanation time(A1T)in the advanced group was longer than that in the non-advanced group,while the second applanation time(A2T)was shorter than that in the non-advanced group,central curvature radius(CCR)and corneal stiffness parameter at applanation 1(SP-A1)were lower than those in the non-advanced group,with statistical significance(P<0.05).A1T(HR=2.768),CCR(HR=7.185),A2T(HR=0.393)and ciliary body photocoagulation(HR=3.246)were correlated with the progression of POAG(P<0.05).The AUC of combined prediction was significantly higher than that of single detection(Z=4.291,3.593,3.915;P<0.001).Conclusion:The corneal feature model based on corneal biomechanical detection has certain value in predicting the progression of POAG disease.

关 键 词：开角型青光眼 角膜特征 角膜生物力学 视野损害 

分 类 号：R775.2[医药卫生—眼科]