Pentacam HR测量圆锥角膜患者角膜地形图参数的重复性  

Repeatability of Pentacam HR in measuring corneal topographic parameters of keratoconus patients

作　　者：王晴[1,3] 杨凯丽 徐丽妍 顾宇伟 范棋 任胜卫 赵东卿 Wang Qing;Yang Kaili;Xu Liyan;Gu Yuwei;Fan Qi;Ren Shengwei;Zhao Dongqing(Department of Ophthalmology,Henan University People's Hospital,Henan Provincial People's Hospital,Henan Eye Hospital,Zhengzhou 450003,China;Department of Ophthalmology,Zhengzhou University People's Hospital,Henan University People's Hospital,Henan Provincial People's Hospital,Henan Eye Hospital,Zhengzhou 450003,China;Zhengzhou Aier Eye Hospital,Zhengzhou 450000,China)

机构地区：[1]河南大学人民医院眼科、河南省人民医院眼科、河南省立眼科医院,郑州450003 [2]郑州大学人民医院眼科、河南大学人民医院眼科、河南省人民医院眼科、河南省立眼科医院,郑州450003 [3]郑州爱尔眼科医院,郑州450000

出　　处：《中华实验眼科杂志》2024年第9期835-846,共12页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金青年科学基金(81200664);河南省省部共建重点项目(SBGJ202002028);河南省中青年卫生健康科技创新杰出青年人才培养项目(YXKC2020023);河南省医学科技攻关计划联合共建项目(LHGJ20200066);河南省立眼科医院基础研究重点专项(20JCZD003);河南省立眼科医院基础研究青年专项(21JCQN006、21JCQN008);2020年度郑州大学青年教师(自然科学)基础研究培育基金(JC202051049)

摘　　要：目的探讨Pentacam HR测量不同严重程度圆锥角膜患者角膜地形图参数的重复性。方法采用诊断试验研究设计,纳入2019年1月至2022年3月就诊于河南省立眼科医院的亚临床圆锥角膜或圆锥角膜患者98例120眼,将患者分为亚临床圆锥角膜组、轻度圆锥角膜组、中度圆锥角膜组和重度圆锥角膜组,每组各30眼。另选取拟行角膜屈光手术者30例30眼作为对照组。由同一医师对每眼进行3次Pentacam HR测量,记录包含角膜前表面、后表面、厚度、综合指数及光密度5个方面共53个参数。通过计算组内标准差、重复性限(r)及公差指数(TI)来比较不同分期圆锥角膜组与对照组间角膜地形图参数的重复性。结果亚临床、轻度、中度及重度圆锥角膜组与对照组所有参数的r值相比,分别有54.71%(29/53)、66.04%(35/53)、90.57%(48/53)、94.34%(50/53)参数TI>0.31。其中角膜前表面垂直中央曲率(Ks)、角膜前表面最大曲率(Kmax)、角膜前表面曲率半径、角膜后表面水平中央曲率(Kf)、角膜后表面曲率半径(PRC)、角膜最薄点厚度(TCT)、0-2 mm、2-6 mm区域角膜前表面光密度(A.0-2 mm、A.2-6 mm)、2-6 mm区域角膜中央层光密度(C.2-6 mm)、0-2 mm及2-6 mm区域全层角膜平均光密度(T.0-2 mm、T.2-6 mm)在亚临床及轻度圆锥角膜组表现出良好的重复性(TI<0.31);围绕Kmax最陡点3 mm区域的平均屈光力、角膜后表面平均曲率、中央圆锥角膜指数参数在亚临床、轻度及中度圆锥角膜组表现出良好的重复性(TI<0.31);围绕Kmax最陡点4 mm、5 mm区域的平均屈光力参数在各组间均表现出良好的重复性(TI<0.31)。结论对于亚临床与轻度圆锥角膜患者,推荐使用角膜后表面Kf、PRC和TCT来监测病情进展;对于监测中度与重度圆锥角膜患者病情,可重点检测围绕Kmax最陡点4 mm、5 mm区域的平均屈光力测量参数。ObjectiveTo investigate the repeatability of corneal topographic parameters with the Pentacam HR in patients with keratoconus of different severity.MethodsA diagnostic test study was performed.A total of 120 eyes from 98 patients with subclinical keratoconus or keratoconus were enrolled at Henan Eye Hospital from January 2019 to March 2022.The patients were divided into subclinical keratoconus group,mild keratoconus group,moderate keratoconus group and severe keratoconus group,with 30 eyes in each group.An additional 30 eyes of 30 subjects undergoing refractive surgery were selected as a control group.Three consecutive Pentacam HR measurements were performed by the same clinician.The recordings included a total of 53 parameters in anterior corneal surface,posterior corneal surface,thickness,composite index,and corneal densitometry.The within-subject standard deviation(Sw),repeatability limit(r)and tolerance index(TI)were calculated to evaluate the repeatability of the parameters between different groups.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Henan Eye Hospital(No.HNEECKY-2019[5]).All subjects were informed of the purpose and significance of the study and signed an informed consent form before enrollment.ResultsCompared with the control group,the TI of the subclinical,mild,moderate and severe keratoconus groups were 54.71%(29/53),66.04%(35/53),90.57%(48/53)and 94.34%(50/53),respectively,higher than 0.31.The steep keratometry(Ks),the maximum keratometry(Kmax)of the anterior corneal surface,the anterior corneal radius of curvature,the flat keratometry(Kf)of the posterior corneal surface,the posterior corneal radius of curvature(PRC),the thinnest corneal thickness(TCT),the average densitometry for the anterior 120μm in the 0-2 mm area(A.0-2 mm),average densitometry for the anterior 120μm in the 2-6 mm area(A.2-6 mm),average densitometry for the central tissue in the 0-2 mm area(C.2-6 mm),average densitometry for the total cornea in the 0-2 mm area(T.0-2 mm)and

关 键 词：圆锥角膜 Pentacam HR 重复性 重复性限 公差指数 

分 类 号：R772.2[医药卫生—眼科]