不同测量方法评估年龄相关性白内障患者晶状体混浊程度结果间的相关性  

Correlation of Different Methods for Evaluating Lens Opacity in Age-Related Cataract Patients

作　　者：高奕晨 杨军 蒋元丰 毛瀚 李美萨 林松 田芳 Gao Yichen;Yang Jun;Jiang Yuanfeng;Mao Han;Li Meisa;Lin Song;Tian Fang(Tianjin Key Laboratory of Retinal Functions and Diseases,Tianjin Branch of National Clinical Research Center for Ocular Disease,Eye Institute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 300384,China)

机构地区：[1]天津医科大学眼科医院、眼视光学院、眼科研究所,国家眼耳鼻喉疾病临床医学研究中心天津市分中心,天津市视网膜功能与疾病重点实验室,天津300384

出　　处：《中华眼视光学与视觉科学杂志》2025年第2期104-111,共8页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-037A)。

摘　　要：目的:比较CASIA2扫频源眼前节相干光层析成像仪、Pentacam三维眼前节分析仪及iTrace视功能分析仪在年龄相关性白内障患者晶状体混浊程度评估中的相关性。方法:系列病例研究。连续收集2021年3月至2023年12月在天津医科大学眼科医院拟行白内障超声乳化吸除联合人工晶状体植入术的白内障患者155例(155眼)。术前对所有患者进行主观检查,包括以最小分辨角的对数(LogMAR)表示的裸眼视力(UDVA)和BCVA,以及裂隙灯显微镜检查结合晶状体混浊分级系统Ⅱ(LOCSⅡ),对晶状体皮质(C)、核(N)和后囊下(P)混浊程度进行评估的LOCSⅡ评分指数;客观检查包括使用CASIA2测量平均晶状体密度(ALD),Pentacam测量晶状体核分级(PNS)及4 mm区域光密度(PDZ2),iTrace测量晶状体功能失调指数(DLI)及晶状体混浊地形图分级(OMG)。采用Spearman相关分析UDVA、BCVA、LOCSⅡ评分指数、ALD、PNS、PDZ2、DLI及OMG之间是否存在相关性,并选择相关性较强的结果进行一元线性回归分析。结果:主客观检查结果中,OMG与UDVA、BCVA、ALD均无相关性(r=0.00~0.12,均P>0.05)。DLI与各项检查结果均呈负相关(r=-0.46~-0.19,均P<0.05),PNS、PDZ2与各项检查结果(除DLI外)均呈正相关(r=0.17~0.82,均P<0.05)。ALD与UDVA、BCVA、LOCSⅡ评分指数均呈正相关(r=0.18~0.20,均P<0.05)。线性回归分析显示BCVA与DLI存在中度相关性(r=-0.46,P<0.001),线性回归方程为BCVA=1.096-0.109×DLI。ALD与PDZ2存在强相关性(r=0.64,P<0.001),线性回归方程为ALD=5.143+2.926×PDZ2。结论:CASIA2、Pentacam及iTrace均可客观评估晶状体混浊程度,其中DLI与主观检查结果相关性相对较强,PDZ2与客观检查结果相关性相对较强,二者可结合参考以综合评估患者晶状体混浊情况。Objective:To compare the correlation between lens opacity measured by swept-source anterior segment optical coherence tomography derice(CASIA2),Scheimpflug-based anterior segment tomography(Pentacam)and visual functional analyzer(iTrace)in age-related cataract patients.Methods:In this case-series study,totally 155 eyes of 155 cataract patients who underwent phacoemulsification in Tianjin Medical University Eye Hospital from March 2021 to December 2023 were consecutively enrolled.Preoperatively,all patients underwent subjective examinations including uncorrected distance visual acuity(UDVA)and BCVA measured in logMAR,as well as the lens opacity classification systemⅡ(LOCSⅡ)degree obtained through slit-lamp examination.The LOCSⅡwas utilized to assess the severity of lens opacities in cortex(C),nucleus(N),and posterior capsular(P).Objective assessments included measurements of average lens density(ALD)using CASIA2,Pentacam nucleus staging(PNS),and Pentacam densitometry of zones 2(PDZ2)using Pentacam,as well as dysfunctional lens index(DLI)and opacity map grade(OMG)using iTrace.Spearman correlation analysis was used to analyze the correlations among UDVA,BCVA,LOCSⅡdegree,ALD,PNS,PDZ2,DLI,and OMG.Subsequently,those results demonstrating strong correlations were selected for further univariate linear regression analysis.Results:Among the objective and subjective examination methods,OMG showed no correlation with UDVA,BCVA and ALD(r=0.00-0.12,all P>0.05).DLI was negatively correlated with other results(r=-0.46--0.19,all P<0.05).PNS and PDZ2 were positively correlated with other results(r=0.17-0.82,all P<0.05)except with DLI.ALD was positively correlated with UDVA,BCVA,and LOCSⅡdegree(r=0.18-0.20,all P<0.05).Linear regression analysis showed a moderate correlation between BCVA and DLI(r=-0.46,P<0.001),with the linear regression equation given as BCVA=1.096-0.109×DLI.A strong correlation was found between ALD and PDZ2(r=0.64,P<0.001),with the linear regression equation given as ALD=5.143+2.926×PDZ2.Conclusions

关 键 词：白内障 晶状体混浊 CASIA2 晶状体功能失调指数 4 mm区域光密度 

分 类 号：R776.1[医药卫生—眼科]