圆锥角膜和顿挫期圆锥角膜的生物力学分析对比及鉴别诊断  

Comparison and differential diagnosis of biomechanical analysis between keratoconus and form fruste keratoconus

作　　者：武志清 魏升升 张耀花 李勇 苏希蕊 杨丹 薛亚林 高金荣 李晶 Wu Zhiqing;Wei Shengsheng;Zhang Yaohua;Li Yong;Su Xirui;Yang Dan;Xue Yalin;Gao Jinrong;Li Jing(Department of Ophthalmology,Hospital of Shaanxi Normal University,Xi'an 710004,China;Shanxi Eye Hospital,Xi’an People’s Hospital(Xi'an Fourth Hospital),Xi'an 710004,China)

机构地区：[1]陕西师范大学医院眼科,西安710004 [2]陕西省眼科医院、西安市人民医院(西安市第四医院),710004

出　　处：《临床眼科杂志》2024年第6期526-530,共5页Journal of Clinical Ophthalmology

基　　金：西安市科技计划项目(22YXYJ0054);陕西省科技计划项目(S2024YFYBSF0599,2024SFYBXM331)。

摘　　要：目的分析对比圆锥角膜、顿挫期圆锥角膜以及正常角膜生物力学参数,探索可视化角膜生物力学分析仪(Corvis ST)在早期圆锥角膜及圆锥角膜诊断中的应用价值。方法回顾性病例研究。纳入诊断单眼圆锥角膜患者37例(37只眼),年龄17~43岁;另一眼均为顿挫期圆锥角膜;屈光不正患者99例(99只眼),年龄20~41岁。应用Corvis ST对三组患者的进行角膜生物力学检查。SPSS 22.0统计软件对数据进行分析,将根据患者数据是否符合使用正态选择方差分析或KruskalWallis H检验。对生物力学参数进行受试者工作特征曲线(ROC)分析,以ROC曲线下面积(AUC)>0.7的参数为阳性结果并记录入表格。结果研究中纳入的所有生物力学参数,在圆锥角膜组和正常角膜组之间差异均有统计学意义(P<0.05);圆锥角膜对比顿挫期圆锥角膜、顿挫期圆锥角膜对比正常角膜组生物力学参数差异数量次之。生物力学参数CBI对圆锥角膜的诊断价值最高,相对正常角膜AUC值为0.992,相对顿挫期角膜AUC值为0.938。对比正常角膜,DA Ratio Max(1 mm)对顿挫期圆锥角膜的诊断价值较高,AUC值为0.797。结论圆锥角膜、顿挫期圆锥角膜及正常角膜之间存在生物力学差异。CBI对圆锥角膜具有极高的诊断价值,DA Ratio Max(1 mm)等生物力学参数对顿挫期圆锥角膜具有较高的诊断价值。Objective To analyze and compare the biomechanical parameters of keratoconus,form fruste keratoconus,and normal cornea,explore the application value of corneal visualization scheimpflug technology(Corvis ST)in the early diagnosis of keratoconus and clinical keratoconus.Methods A retrospective study.37 cases(37 eyes)of diagnosed unilateral keratoconus patients were included.The other eye had a form fruste keratoconus;99 patients(99 eyes)with refractive errors.Perform corneal biomechanical examination on three groups of patients using Corvis ST.SPSS 22.0 statistical software will be used to analyze the data,and normal selection analysis of variance or Kruskal Wallis H-test will be used based on whether the patient data meets the criteria.Perform receiver operating characteristic(ROC)analysis on biomechanical parameters,with positive results for parameters with an area under the ROC curve(AUC)greater than 0.7,and record in the table.Results All biomechanical parameters included in the study showed statistical differencesbetween the keratoconus group and the normal cornea group(P<0.05).The number of differences in biomechanical parameters of keratoconus VS form fruste keratoconus and form fruste keratoconus VS normal cornea group decreased.The biomechanical parameter corvis biomechanical index(CBI)has the highest diagnostic efficiency for keratoconus,with a relative AUC value of 0.992 for normal corneas and 0.938 for form fruste corneas.Compared to normal corneas,DA Ratio Max(1 mm)has a higher diagnostic efficiency for form fruste keratoconus,with an AUC value of 0.797.Conclusions There are biomechanical differences in keratoconus,form fruste keratoconus,and normal cornea.CBI has the highest diagnostic efficiency for keratoconus,and biomechanical parameters such as DA Ratio Max(1 mm)have a high diagnostic efficiency for form fruste keratoconus.

关 键 词：顿挫期圆锥角膜 圆锥角膜 生物力学 可视化角膜生物力学分析仪 

分 类 号：G63[文化科学—教育学]