Fujioka Miyuki, Nakamura Makoto, Tatsumi Yasuko, Kusuhara Azusa, Maeda Hidetaka, Negi Akira
Division of Ophthalmology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Curr Eye Res. 2007 Feb;32(2):89-94. doi: 10.1080/02713680601115010.
Although central corneal thickness (CCT) can be measured by several methods, interchangeability of different modalities has not been fully investigated. CCT is known to correlate with intraocular pressure (IOP). The aim of this study was to evaluate the agreement of Pentacam Scheimpflug system with noncontact specular microscopy (NCSM) and ultrasound (US) pachymetry in measuring CCT and the relation between IOP taken with Goldmann applanation tonometer (GAT) and the CCT measured with these three methods.
The right eyes of 135 enrolled persons without antiglaucoma drug use (100 females and 35 males), who comprised 32 patients with primary open-angle glaucoma, 14 with ocular hypertension, 45 with primary angle-closure glaucoma, and 44 controls, were studied. Intermethod comparison of CCT was made by the 95% limits of agreement analysis according to Bland and Altman. Linear regression analysis was used to assess the relationship between IOP and CCT taken with each modality.
The mean CCT (+/-SD) taken with Scheimpflug, US, and NCSM was 559.49 +/- 38.44 microm, 553.01 +/- 39.33 microm, and 552.04 +/- 42.95 microm, respectively. The average values of CCT taken with the three instruments were not significantly different (one-factor ANOVA; p = 0.26), although the marginal mean difference between Scheimpflug and US or NCSM was statistically significant (paired t test; p = 0.0009 and 0.005, respectively). The 95% limits of agreement were 6.47 +/- 43.21 microm between Scheimpflug and US, 7.45 +/- 58.86 microm between Scheimpflug and NCSM, and 0.98 +/- 51.69 microm between US and NCSM. There was a positive association between IOP and CCT measured with US or NCSM, whereas there was no correlation between IOP and CCT measured with Scheimpflug.
Although CCT values measured with Scheimpflug, US, and NCSM are closely similar, clinicians should keep in mind that these methods are not simply interchangeable.
尽管中央角膜厚度（CCT）可通过多种方法测量，但不同测量方式的互换性尚未得到充分研究。已知CCT与眼压（IOP）相关。本研究的目的是评估Pentacam Scheimpflug系统与非接触式角膜内皮显微镜检查（NCSM）以及超声（US）测厚法在测量CCT方面的一致性，以及用Goldmann压平眼压计（GAT）测量的IOP与用这三种方法测量的CCT之间的关系。
对135名未使用抗青光眼药物的受试者（100名女性和35名男性）的右眼进行研究，其中包括32例原发性开角型青光眼患者、14例高眼压症患者、45例原发性闭角型青光眼患者和44例对照者。根据Bland和Altman的方法，通过95%一致性界限分析对CCT的不同测量方法进行比较。采用线性回归分析评估每种测量方式下IOP与CCT之间的关系。
Scheimpflug、US和NCSM测量的平均CCT（±标准差）分别为559.49±38.44微米、553.01±39.33微米和552.04±42.95微米。尽管Scheimpflug与US或NCSM之间的边缘平均差异具有统计学意义（配对t检验；p分别为0.0009和0.005），但三种仪器测量的CCT平均值无显著差异（单因素方差分析；p = 0.26）。Scheimpflug与US之间的95%一致性界限为6.47±43.21微米，Scheimpflug与NCSM之间为7.45±58.86微米，US与NCSM之间为0.98±51.69微米。用US或NCSM测量的IOP与CCT之间呈正相关，而用Scheimpflug测量的IOP与CCT之间无相关性。
尽管用Scheimpflug、US和NCSM测量的CCT值非常相似，但临床医生应牢记这些方法并非简单可互换。
