AS-OCT测量前部巩膜形态在巩膜镜验配和设计中的应用  

Application of Anterior Segment Optical Coherence Tomography for Measuring Anterior Scleral Shape in Scleral Lens Fitting and Design

作　　者：胡艳 徐珊珊[1] 齐艳 陈一芳 薛劲松[1] Yan Hu;Shanshan Xu;Yan Qi;Yifang Chen;Jinsong Xue(The Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属眼科医院,南京210029

出　　处：《中华眼视光学与视觉科学杂志》2024年第10期733-742,共10页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:通过大直径眼前节光学相干断层扫描仪(AS-OCT)获取眼前段参数并评估眼前段形态特征,以指导临床上巩膜镜验配和设计。方法:系列病例研究。随机选取2021年9月—10月于南京医科大学附属眼科医院接触镜专科就诊的屈光不正患者30例(60眼)。所有受检者通过AS-OCT获取眼前部4个子午线方向(即0-180°水平方向、90°-270°垂直方向、45°-225°和135°-315°斜向方向)的矢状面图像和角巩膜地形图,测量不同弦长的角巩膜矢高、角巩膜连接角(CSJ)、角巩膜角和角巩膜曲率等,并进一步分析双眼眼前段巩膜形态特征。采用配对样本t检验对双眼形态参数进行统计分析。结果:在15.0 mm处,左右眼均是水平方向巩膜矢高最小[右眼(3659±167)μm,左眼(3682±177)μm],右眼垂直方向巩膜矢高最大[(3746±143)μm],左眼鼻上颞下方向巩膜矢高最大[(3729±163)μm];左右眼上方和下方方位巩膜矢高差差异有统计学意义(t_(右眼)=-5.29,P<0.001;t_(左眼)=-4.41,P<0.001);在15 mm处,双眼互相垂直子午线巩膜矢高差≥150μm的占比为42%(右眼37%,左眼47%);左右眼所有方位CSJ均小于180°。在15.0 mm处左右眼颞下方位巩膜角最大(右眼38.6°±2.1°,左眼37.9°±2.6°),鼻上方位巩膜角最小(右眼35.1°±2.2°,左眼35.1°±2.5°)。结论:大直径AS-OCT能够全面了解眼前段的形态特征,巩膜形态常呈非旋转对称性,鼻侧较颞侧巩膜形态更平坦,上下方巩膜矢高差异大,可进一步指导非对称设计及环曲面设计巩膜镜的验配和设计。Objective:To determine the anterior segment parameters using anterior segment optical coherence tomography(AS-OCT)and evaluate their morphological characteristics for guiding scleral lens fitting and design in a clinical context.Methods:This was a serial case study.Thirty participants(60 eyes)were randomly selected from patients who visited the Contact Lens Clinic at the Affiliated Eye Hospital of Nanjing Medical University from September to October 2021.AS-OCT was used to obtain sagittal section images and angle-to-angle topography maps of the anterior segment in four meridians at 0-180°horizontal direction,90°-270°vertical direction,45°-225°and 135°-315°oblique direction in all participants.Sagittal height at different chord lengths,angle-to-angle measurements,corneoscleral angle,and corneoscleral curvature were measured.The anterior scleral morphology features of both eyes were analyzed,and the paired t-test was used in this study.Results:At 15.0 mm,the sagittal scleral height of both eyes was the smallest in the horizontal direction(3659±167μm in the right eye,3682±177μm in the left eye).The largest sagittal scleral height was in the vertical direction(3746±143μm)in the right eye,and in the superonasal direction(3729±163μm)in the left eye.The difference of scleral sagittal height between the superior and inferior directions of the both eyes was significant(t _(right eye)=-5.29,P<0.001;t_( left eye)=-4.42,P<0.001).At 15 mm,42%(37%in right eye,47%in left eye)had scleral sagittal height difference≥150μm.CSJ was less than 180°in all directions.At 15.0 mm,the scleral angle of both eyes was largest in infratemporal position(38.6°±2.1°in the right eye,37.9°±2.6°in the left eye),and smallest in nasal superior position(35.1°±2.2°in the right eye,35.0°±2.5°in the left eye).Conclusions:Large diameter AS-OCT can provide a complete picture of the anterior segment.The shape of sclera is often non-rotationally symmetric,the nasal sclera is flatter than the temporal sclera,and the sagittal heig

关 键 词：巩膜 眼前节光学相干断层扫描仪 巩膜形态 巩膜镜 

分 类 号：R778.1[医药卫生—眼科]