常规和高分辨率Scheimpflug成像设备之间客观和主观屈光手术筛查参数的比较。
Comparison of objective and subjective refractive surgery screening parameters between regular and high-resolution Scheimpflug imaging devices.
作者信息
Randleman J Bradley, Akhtar Jihan, Lynn Michael J, Ambrósio Renato, Dupps William J, Krueger Ronald R, Klyce Stephen D
机构信息
From the Department of Ophthalmology (Randleman, Akhtar) and the Department of Biostatistics and Bioinformatics (Lynn), Rollins School of Public Health, Emory University, and Emory Vision (Randleman, Akhtar), Emory Eye Center, Atlanta, Georgia, the Cleveland Clinic Cole Eye Institute (Dupps, Krueger), the Department of Biomedical Engineering (Dupps), the Lerner Research Institute and the Transplant Center (Dupps), Surgery Institute, Cleveland Clinic, the Department of Biomedical Engineering (Dupps), Case Western Reserve University, Cleveland, Ohio, the Department of Ophthalmology (Klyce), Mount Sinai School of Medicine, New York, New York, USA; Instituto de Olhos Renato Ambrósio (Ambrósio), Rio de Janeiro Corneal Tomography and Biomechanics Study Group (Ambrósio), Rio de Janeiro, the Department for Ophthalmology of the Federal University of São Paulo (Ambrósio), São Paulo, Brazil.
From the Department of Ophthalmology (Randleman, Akhtar) and the Department of Biostatistics and Bioinformatics (Lynn), Rollins School of Public Health, Emory University, and Emory Vision (Randleman, Akhtar), Emory Eye Center, Atlanta, Georgia, the Cleveland Clinic Cole Eye Institute (Dupps, Krueger), the Department of Biomedical Engineering (Dupps), the Lerner Research Institute and the Transplant Center (Dupps), Surgery Institute, Cleveland Clinic, the Department of Biomedical Engineering (Dupps), Case Western Reserve University, Cleveland, Ohio, the Department of Ophthalmology (Klyce), Mount Sinai School of Medicine, New York, New York, USA; Instituto de Olhos Renato Ambrósio (Ambrósio), Rio de Janeiro Corneal Tomography and Biomechanics Study Group (Ambrósio), Rio de Janeiro, the Department for Ophthalmology of the Federal University of São Paulo (Ambrósio), São Paulo, Brazil.
出版信息
J Cataract Refract Surg. 2015 Feb;41(2):286-94. doi: 10.1016/j.jcrs.2014.06.026. Epub 2014 Dec 20.
PURPOSE
To compare objective and subjective metrics from regular and high-resolution Scheimpflug devices (Pentacam) to determine their equivalence and interchangeability for refractive surgery screening.
SETTING
Emory Vision at Emory University, Atlanta, Georgia, USA.
DESIGN
Retrospective comparative case series.
METHODS
Eyes of consecutive screened refractive surgery patients were evaluated with high-resolution and regular Scheimpflug devices. Objective parameters evaluated included keratometry (K) values, central corneal thickness (CCT), and device-generated keratoconus screening indices. Masked expert reviewers subjectively graded images as normal, suspicious, or abnormal.
RESULTS
One hundred eyes of 50 patients were evaluated. The mean K values were not significantly different (anterior K: high resolution 1.21 diopters [D] ± 1.13 (SD) versus regular 1.15 ± 1.16 D, P = 0.73; posterior K: 0.34 ± 0.23 D versus regular 0.35 ± 0.23 D, P = .67). The mean CCT was significantly thinner in the high-resolution group (514.7 ± 26.6 μm versus 527.6 ± 27.6 μm (P < .0001) with limits of agreement of -12.9 to +17.5 μm. Most keratoconus screening indices were more suspicious with the high-resolution device than with the regular device except the indices of height asymmetry and height deviation. Subjectively, 60% of cases received the same score, high resolution was more suspicious in 28% of cases, and regular was more suspicious in 12% of cases; there was only slight subjective agreement between technologies (κ = 0.26 to 0.31).
CONCLUSIONS
Regular and high-resolution Scheimpflug imaging devices generated different objective values and significantly different subjective interpretations with poor inter-reviewer agreement. The high-resolution device provided a more conservative overall output. For refractive surgical screening, the 2 devices are not interchangeable.
FINANCIAL DISCLOSURE
Proprietary or commercial disclosures are listed after the references.
目的
比较常规和高分辨率的眼前节分析系统（Pentacam）的客观和主观指标，以确定它们在屈光手术筛查中的等效性和互换性。
地点
美国佐治亚州亚特兰大市埃默里大学的埃默里视力中心。
设计
回顾性比较病例系列。
方法
使用高分辨率和常规的眼前节分析系统对连续接受筛查的屈光手术患者的眼睛进行评估。评估的客观参数包括角膜曲率（K）值、中央角膜厚度（CCT）以及仪器生成的圆锥角膜筛查指数。由经验丰富的专家审阅者对图像进行主观分级，分为正常、可疑或异常。
结果
对50例患者的100只眼睛进行了评估。平均K值无显著差异（前表面K值：高分辨率组为1.21屈光度[D]±1.13（标准差），常规组为1.15±1.16 D，P = 0.73；后表面K值：高分辨率组为0.34±0.23 D，常规组为0.35±0.23 D，P = 0.67）。高分辨率组的平均CCT显著更薄（514.7±26.6μm，而常规组为527.6±27.6μm，P < 0.0001），一致性界限为-12.9至+17.5μm。除了高度不对称指数和高度偏差指数外，大多数圆锥角膜筛查指数在高分辨率仪器下比常规仪器下更可疑。主观上，60%的病例获得相同评分，28%的病例在高分辨率下更可疑，12%的病例在常规仪器下更可疑；两种技术之间只有轻微的主观一致性（κ = 0.26至0.31）。
结论
常规和高分辨率的眼前节分析成像设备产生不同的客观值和显著不同的主观解读，审阅者之间的一致性较差。高分辨率设备提供了更保守的总体输出。对于屈光手术筛查，这两种设备不可互换。
财务披露
专有或商业披露信息列在参考文献之后。
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