Sahebjada Srujana, Xie Jing, Chan Elsie, Snibson Grant, Daniel Mark, Baird Paul N
*BSOptom, PhD †PhD ‡FRANZCO Centre for Eye Research Australia, East Melbourne, Victoria, Australia (all authors); The University of Melbourne, East Melbourne, Victoria, Australia (SS, PNB); and Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia (GS, MD).
Optom Vis Sci. 2014 Jul;91(7):803-9. doi: 10.1097/OPX.0000000000000295.
To assess anterior segment parameters of eyes with keratoconus (KC) at different clinical stages of disease.
KC and non-KC patients were recruited from public and private clinics in Melbourne, Australia. Axial length (AL), mean front corneal curvature (Front Km), mean back corneal curvature (Back Km), central corneal thickness (CCT), corneal thickness at the apex (CTA), corneal thickness at the thinnest point (CTT), anterior chamber depth (ACD), and corneal volume were noted for all the eyes.
A total of 181 individuals comprising 44 (24.3%) subclinical KC, 118 (65.2%) clinical KC, and 19 (10.5%) control subjects were analyzed. Significant differences were noticed between the subclinical KC and control group for ACD and CTT, whereas between clinical and control groups, significant differences were obtained for AL, CCT, CTA, CTT, and ACD (p < 0.05). In the case of mild, moderate, and severe KC groups, Back Km, CCT, CTA, and CTT were significantly associated (p < 0.001) with increasing disease severity. We further did receiver operating characteristic analysis to confirm the importance of pachymetric parameters in differentiating between control and KC eyes. The area under the receiver operating characteristic curve value of CTT for subclinical and clinical KC was 0.68 and 0.82, which showed that it may be a potential marker for the early detection and prevention of KC.
This study identified the anterior chamber parameters that differ between subclinical and clinical KC as well as the severity of KC. There is a significant reduction in CTT between control and subclinical eyes, although there are no significant alterations in Front and Back Km or AL between the two groups. Also, a progressive reduction in the pachymetric readings at the pupil center, apex, and thinnest corneal point was identified when comparing mild to severe KC groups. Thus, corneal thickness represents an important parameter that needs to be considered in monitoring KC disease severity.
评估圆锥角膜（KC）患者在疾病不同临床阶段的眼前节参数。
从澳大利亚墨尔本的公立和私立诊所招募KC患者和非KC患者。记录所有眼睛的眼轴长度（AL）、角膜前表面平均曲率（Front Km）、角膜后表面平均曲率（Back Km）、中央角膜厚度（CCT）、角膜顶点厚度（CTA）、角膜最薄点厚度（CTT）、前房深度（ACD）和角膜体积。
共分析了181例个体，其中包括44例（24.3%）亚临床KC患者、118例（65.2%）临床KC患者和19例（10.5%）对照者。亚临床KC组与对照组在ACD和CTT方面存在显著差异，而临床KC组与对照组在AL、CCT、CTA、CTT和ACD方面存在显著差异（p < 0.05）。在轻度、中度和重度KC组中，Back Km、CCT、CTA和CTT与疾病严重程度增加显著相关（p < 0.001）。我们进一步进行了受试者工作特征分析，以确认角膜厚度测量参数在区分对照眼和KC眼中的重要性。亚临床和临床KC的CTT受试者工作特征曲线下面积值分别为0.68和0.82，这表明它可能是早期检测和预防KC的潜在标志物。
本研究确定了亚临床和临床KC之间以及KC严重程度不同的眼前房参数。对照组和亚临床眼之间CTT显著降低，尽管两组之间Front Km、Back Km或AL没有显著变化。此外，比较轻度至重度KC组时，发现瞳孔中心、顶点和角膜最薄点的角膜厚度测量值逐渐降低。因此，角膜厚度是监测KC疾病严重程度时需要考虑的一个重要参数。
