Kocamış Sücattin İlker, Çakmak Hasan Basri, Çağıl Nurullah, Toklu Yasin
a Ophthalmology Department , Ardahan State Hospital , Ardahan , Turkey .
b Ophthalmology Department , Yıldırım Beyazıt University School of Medicine , Ankara , Turkey , and.
Semin Ophthalmol. 2016;31(3):203-9. doi: 10.3109/08820538.2014.914234. Epub 2014 May 19.
The aim of this study was to investigate the sensitivity, specificity, and accuracy of The Cone Location and Magnitude Index (CLMI) in keratoconus diagnosis.
301 eyes of 159 keratoconus patients and 394 eyes of 265 refractive surgery candidates as a control group were enrolled in this retrospective clinical study. CLMI was compared with keratometric corneal topography parameters, wavefront aberrations, and pachymetry data derived from optical coherence tomography using independent sample t-tests and ROC curves. Logistic regression analysis was applied to determine the most accurate parameter in keratoconus diagnosis. Pearson's correlation analysis was used to determine the correlation between CLMI and the other measurements.
Average axial CLMI (aCLMI) was 8.19 ± 6.15 D in the keratoconus group and 0.83 ± 0.62 D in the control group (p = 0.001). aCLMI had the greatest sensitivity (89%), specificity (94%), and accuracy (92%) for the keratoconus diagnosis at the best cut-off point of 1.82 according to the ROC curve. Logistic regression analysis selected aCLMI as the most accurate measurement among the other parameters (accuracy 92.8%). aCLMI showed strongest correlations with coma-like aberrations (r = 0.881), total high-order aberrations (r = 0.858), and vertical coma (r = -0.814), respectively.
CLMI is a robust index for screening keratoconus with high sensitivity, specificity, and accuracy.
本研究旨在探讨圆锥角膜位置和大小指数（CLMI）在圆锥角膜诊断中的敏感性、特异性和准确性。
本回顾性临床研究纳入了159例圆锥角膜患者的301只眼和265例屈光手术候选者的394只眼作为对照组。使用独立样本t检验和ROC曲线，将CLMI与角膜曲率计角膜地形图参数、波前像差以及光学相干断层扫描获得的角膜厚度数据进行比较。应用逻辑回归分析确定圆锥角膜诊断中最准确的参数。采用Pearson相关分析确定CLMI与其他测量值之间的相关性。
圆锥角膜组的平均轴向CLMI（aCLMI）为8.19±6.15 D，对照组为0.83±0.62 D（p = 0.001）。根据ROC曲线，在最佳截断点为1.82时，aCLMI对圆锥角膜诊断具有最高的敏感性（89%）、特异性（94%）和准确性（92%）。逻辑回归分析选择aCLMI作为其他参数中最准确的测量值（准确性92.8%）。aCLMI分别与类彗差（r = 0.881）、总高阶像差（r = 0.858）和垂直彗差（r = -0.814）显示出最强的相关性。
CLMI是一种用于筛查圆锥角膜的可靠指标，具有高敏感性、特异性和准确性。
