通过Corvis ST分析原发性开角型青光眼患者和健康受试者的角膜变形反应。

Corneal Deformation Response in Patients With Primary Open-Angle Glaucoma and in Healthy Subjects Analyzed by Corvis ST.

作者信息

Wang Wei, Du Shaolin, Zhang Xiulan

出版信息

Invest Ophthalmol Vis Sci. 2015 Aug;56(9):5557-65. doi: 10.1167/iovs.15-16926.

DOI:10.1167/iovs.15-16926

PMID:26305527

Abstract

PURPOSE

To compare corneal deformation response between patients with primary open-angle glaucoma (POAG) and healthy subjects. A prevalent case-control study was conducted, followed by an integrated meta-analysis.

METHODS

Primary open-angle glaucoma was confirmed by presence of glaucomatous optic disc damage with corresponding visual field defect after excluding secondary causes. Age-matched controls were recruited. Corvis ST (CST) was used to measure 10 parameters of corneal deformation response and central corneal thickness (CCT). The association between parameters of deformation response and clinical factors was assessed by the linear regression analyses. Differences in deformation response between POAG and healthy subjects were compared after adjusting for other factors. Eligible studies were identified by a systematic search of the PubMed, ISI Web of Science, and Embase databases; Web sites of professional associations; and the Google Scholar engine.

RESULTS

This study included 37 patients with POAG and 36 healthy controls. Significant associations were found between IOP and the first applanation time (A1T), first applanation velocity (A1V), second applanation time (A2T), and second applanation velocity (A2V) in each group. The deformation amplitude (DA), A1V, and A2T were lower in the POAG group, whereas the A1T, A2V and peak distance (PD) were greater in the POAG group than in the healthy controls (all P < 0.05). Ten separate studies plus the present study, involving 691 patients with POAG and 740 controls, were ultimately meta-analyzed. The significant differences in the DA, A1T, and A2T were further confirmed, with pooled weighted mean difference (WMD) of 0.13 mm (95% CI 0.04-0.23; P = 0.008) for A1T, -0.13 mm (95% CI -0.21 to -0.05; P = 0.001) for DA, and -0.46 ms (95% CI -0.70 to -0.22; P < 0.001) for A2T.

CONCLUSIONS

The corneal response parameters provided by CST are informative for the assessment of corneal biomechanics. Patients with POAG showed significantly greater A1T and lower DA and A2T values than healthy controls, indicating a less deformable cornea in POAG patients.

摘要

目的

比较原发性开角型青光眼（POAG）患者与健康受试者的角膜变形反应。进行了一项现况病例对照研究，随后进行了综合荟萃分析。

方法

排除继发性病因后，根据青光眼性视盘损害及相应的视野缺损确诊原发性开角型青光眼。招募年龄匹配的对照组。使用Corvis ST（CST）测量角膜变形反应的10个参数和中央角膜厚度（CCT）。通过线性回归分析评估变形反应参数与临床因素之间的关联。在调整其他因素后，比较POAG患者与健康受试者之间的变形反应差异。通过系统检索PubMed、ISI Web of Science和Embase数据库、专业协会网站以及谷歌学术引擎确定符合条件的研究。

结果

本研究纳入37例POAG患者和36例健康对照。在每组中，眼压与首次压平时间（A1T）、首次压平速度（A1V）、第二次压平时间（A2T）和第二次压平速度（A2V）之间存在显著关联。POAG组的变形幅度（DA）、A1V和A2T较低，而POAG组的A1T、A2V和峰值距离（PD）高于健康对照组（所有P<0.05）。最终对包括本研究在内的10项独立研究进行荟萃分析，共纳入691例POAG患者和740例对照。DA、A1T和A2T的显著差异得到进一步证实，A1T的合并加权平均差（WMD）为0.13mm（95%CI 0.04 - 0.23；P = 0.008），DA为 - 0.13mm（95%CI - 0.21至 - 0.05；P = 0.001），A2T为 - 0.46ms（95%CI - 0.70至 - 0.22；P < 0.001）。