基于光学相干断层扫描技术分析健康人群和圆锥角膜患者的巩膜形态差异  

Difference analysis of scleral morphology in healthy people and keratoconus patients based on OCT

作　　者：万超 刘波 余涛 吴楠 董玉志 杨于力 WAN Chao;LIU Bo;YU Tao;WU Nan;DONG Yuzhi;YANG Yuli(Department of Ophthalmology,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院眼科,重庆400038

出　　处：《检验医学与临床》2024年第20期3079-3083,共5页Laboratory Medicine and Clinic

基　　金：国家自然科学基金面上项目(82271055);重庆市科卫联合医学科研项目面上项目(2022MSXM051);重庆市科卫联合医学科研项目(2024MSXM016)。

摘　　要：目的使用光学相干断层扫描技术(OCT)扫描并测量健康眼和圆锥角膜眼的巩膜形态,并评估两者之间的差异,以期为巩膜镜的精准验配提供更科学的依据。方法选取2024年3月至2024年5月陆军军医大学第一附属医院收治的经OCT检查的63例受试者作为研究对象。根据是否患病,将其分为健康组(42例,80眼)和圆锥角膜组(21例,40眼)。每位受试者都接受眼前节OCT检查,采集角-巩膜地形图,测量并获得角巩膜连接角(CSJA)、巩膜角(SA)、矢高(SH)和巩膜环曲(ST)等角巩膜参数。分别比较不同弦长、不同方位的上述参数之间的差异,同时对两组受试者的这些参数进行比较。结果健康组上方、颞侧、下方、鼻侧CSJA比较,差异有统计学意义(P<0.001);圆锥角膜组上方、颞侧、下方、鼻侧CSJA比较,差异有统计学意义(P<0.001)。圆锥角膜组鼻侧CSJA小于健康组,差异有统计学意义(P<0.05)。健康组10.0 mm弦长处鼻上方SA最大,颞下方最小,12.8 mm、14.0 mm、15.0 mm弦长处SA均是颞侧最大,鼻上方最小。圆锥角膜组10.0 mm弦长处鼻上方SA最大,颞侧最小;12.8 mm弦长处颞侧SA最大,鼻上方最小;14.0 mm和15.0 mm弦长处颞下方SA最大,鼻侧最小。圆锥角膜组12.8 mm弦长处上方、颞侧、鼻下方,14.0 mm弦长处鼻上方、下方、鼻下方,15.0 mm弦长处鼻上方SA均大于健康组,差异均有统计学意义(P<0.05)。两组10.0、12.8、14.0、15.0 mm弦长处水平方向和垂直方向SH比较,差异均无统计学意义(P>0.05);圆锥角膜组10.0、12.8、14.0、15.0 mm弦长处SH均高于健康组,差异均有统计学意义(P<0.05)。圆锥角膜组10.0、12.8、14.0、15.0 mm弦长处ST均大于健康组,差异均有统计学意义(P<0.05)。结论巩膜整体是不规则的,尤其是水平方向极不对称,并且随着弦长增加,这种不规则程度越大。相较于健康眼,圆锥角膜眼呈现出更加不规则的形态。Objective To measure the scleral morphology of healthy eyes and keratoconus eyes by optical coherence tomography(OCT),and to evaluate the differences between them,so as to provide a more scientific basis for the accurate fitting of scleral lenses.Methods A total of 63 subjects with OCT enrolled in the First Affiliated Hospital of Army Medical University from March 2024 to May 2024 were selected as the research subjects,who were divided into healthy group(42 cases,80 eyes)and keratoconus group(21 cases,40 eyes)aciording to whether they were sick or not.The corneoscleral junction Angle(CSJA),scleral Angle(SA),sagittal height(SH)and scleral curvature(ST)were measured and obtained.The differences of these parameters between different chord lengths and different orientations were compared,and these parameters were compared between the two groups of subjects.Results There were significant differences in CSJA between the superior,temporal,inferior and nasal sides in the healthy group(P<0.001).There were significant differences in CSJA between the superior,temporal,inferior and nasal sides in the keratoconus group(P<0.001).The nasal CSJA of the keratoconus group was smaller than that of the healthy group,and the difference was statistically significant(P<0.05).In the healthy group,the SA was the largest in the upper nose and the smallest in the lower temporal with the chord length of 10.0 mm.The SA was the largest in the temporal with the chord length of 12.8 mm,14.0 mm and 15.0 mm,and the smallest in the upper nose.In the keratoconus group,the SA was the largest in the supernasal region and the smallest in the temporal region at 10 mm string length.At 12.8 mm string length,SA was the largest in the temporal region and the smallest in the supernasal region.At 14.0 mm and 15.0 mm chord lengths,SA was the largest in the inferior temporal region and the smallest in the nasal region.The SA of 12.8 mm chord length superior,temporal and nasal inferior in keratoconus group,14.0 mm chord length superior,inferior and nasal inferi

关 键 词：巩膜形态 健康眼 圆锥角膜 巩膜镜 巩膜角 

分 类 号：R778.1[医药卫生—眼科] R778.3[医药卫生—临床医学]