Fontes Bruno Machado, Ambrósio Junior Renato, Jardim Daniela, Velarde Guillermo Coca, Nosé Walton
Ophthalmology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2010 Jul-Aug;73(4):333-7. doi: 10.1590/s0004-27492010000400006.
To evaluate the sensitivity, specificity, and test accuracy of corneal biomechanical metrics and anterior segment data in differentiating keratoconus from healthy corneas.
Comparative case series. Patients with and without keratoconus (gender and age-matched) were submitted for complete eye examinations including corneal hysteresis (CH) and corneal resistance factor (CRF) as measured by the Ocular Response Analyzer and anterior segment data as gathered through Pentacam assessments. The anterior segment data measurement included average central keratometric readings (K-Ave), corneal astigmatism (CA), central corneal thickness (CCT), anterior chamber depth (AC depth) and corneal volume (CV). All parameters were assessed, compared and analyzed. A receiver operating characteristic (ROC) curve was used to identify the best cutoff point by which to maximize the sensitivity and specificity of discriminating keratoconus from normal corneas for each data category.
Seventy seven eyes from forty three patients (24 male, 19 female) with keratoconus and eighty six eyes from forty three (24 male, 19 female) healthy controls were enrolled. ROC curve analysis showed poor overall predictive accuracy for all studied parameters in differentiating keratoconus from normal corneas. The highest sensitivity (79.2%) was obtained for both AC depth and CH (cutoff points 3.22 mm and 9.39 mmHg respectively). The best specificity (89.5%) and test accuracy (80.34%) were obtained for CA (cutoff point of 2.2 D).
When considered together, studied parameters showed statistical differences between groups. However, when considered independently they presented low sensitivity, specificity and test accuracy in differentiating keratoconus from healthy corneas.
评估角膜生物力学指标和眼前节数据在区分圆锥角膜与健康角膜方面的敏感性、特异性和检测准确性。
比较病例系列研究。对患有和未患有圆锥角膜的患者（性别和年龄匹配）进行全面的眼部检查，包括通过眼反应分析仪测量的角膜滞后（CH）和角膜阻力因子（CRF），以及通过Pentacam评估收集的眼前节数据。眼前节数据测量包括平均中央角膜曲率读数（K-Ave）、角膜散光（CA）、中央角膜厚度（CCT）、前房深度（AC深度）和角膜体积（CV）。对所有参数进行评估、比较和分析。使用受试者工作特征（ROC）曲线确定最佳截断点，以最大限度地提高每个数据类别区分圆锥角膜与正常角膜的敏感性和特异性。
纳入了43例患者（24例男性，19例女性）的77只圆锥角膜眼和43例（24例男性，19例女性）健康对照者的86只眼。ROC曲线分析显示，在区分圆锥角膜与正常角膜方面，所有研究参数的总体预测准确性较差。AC深度和CH的敏感性最高（均为79.2%），截断点分别为3.22mm和9.39mmHg。CA的特异性最佳（89.5%），检测准确性最佳（80.34%），截断点为2.2D。
综合考虑时，研究参数在两组之间显示出统计学差异。然而，单独考虑时，它们在区分圆锥角膜与健康角膜方面的敏感性、特异性和检测准确性较低。
