Piñero David P, Pérez-Cambrodí Rafael J, Soto-Negro Roberto, Ruiz-Fortes Pedro, Artola Alberto
Ocular Surface and Cornea Unit, Department of Ophthalmology, Oftalmar, Hospital Internacional Medimar, C/Padre Arrupe, 20, 03016, Alicante, Spain.
Foundation for the Visual Quality FUNCAVIS, Fundación para la Calidad Visual, Alicante, Spain.
Graefes Arch Clin Exp Ophthalmol. 2015 Dec;253(12):2229-37. doi: 10.1007/s00417-015-3169-x. Epub 2015 Sep 7.
We aimed to characterize the distribution of the vector parameters ocular residual astigmatism (ORA) and topography disparity (TD) in a sample of clinical and subclinical keratoconus eyes, and to evaluate their diagnostic value to discriminate between these conditions and healthy corneas.
This study comprised a total of 43 keratoconic eyes (27 patients, 17-73 years) (keratoconus group), 11 subclinical keratoconus eyes (eight patients, 11-54 years) (subclinical keratoconus group) and 101 healthy eyes (101 patients, 15-64 years) (control group). In all cases, a complete corneal analysis was performed using a Scheimpflug photography-based topography system. Anterior corneal topographic data was imported from it to the iASSORT software (ASSORT Pty. Ltd), which allowed the calculation of ORA and TD.
Mean magnitude of the ORA was 3.23 ± 2.38, 1.16 ± 0.50 and 0.79 ± 0.43 D in the keratoconus, subclinical keratoconus and control groups, respectively (p < 0.001). Mean magnitude of the TD was 9.04 ± 8.08, 2.69 ± 2.42 and 0.89 ± 0.50 D in the keratoconus, subclinical keratoconus and control groups, respectively (p < 0.001). Good diagnostic performance of ORA (cutoff point: 1.21 D, sensitivity 83.7 %, specificity 87.1 %) and TD (cutoff point: 1.64 D, sensitivity 93.3 %, specificity 92.1 %) was found for the detection of keratoconus. The diagnostic ability of these parameters for the detection of subclinical keratoconus was more limited (ORA: cutoff 1.17 D, sensitivity 60.0 %, specificity 84.2 %; TD: cutoff 1.29 D, sensitivity 80.0 %, specificity 80.2 %).
The vector parameters ORA and TD are able to discriminate with good levels of precision between keratoconus and healthy corneas. For the detection of subclinical keratoconus, only TD seems to be valid.
我们旨在描述临床和亚临床圆锥角膜眼样本中矢量参数眼残余散光（ORA）和地形差异（TD）的分布情况，并评估它们在区分这些情况与健康角膜方面的诊断价值。
本研究共纳入43只圆锥角膜眼（27例患者，年龄17 - 73岁）（圆锥角膜组）、11只亚临床圆锥角膜眼（8例患者，年龄11 - 54岁）（亚临床圆锥角膜组）和101只健康眼（101例患者，年龄15 - 64岁）（对照组）。所有病例均使用基于Scheimpflug摄影的地形系统进行完整的角膜分析。将前角膜地形数据从该系统导入iASSORT软件（ASSORT私人有限公司），该软件可计算ORA和TD。
圆锥角膜组、亚临床圆锥角膜组和对照组的ORA平均大小分别为3.23±2.38、1.16±0.50和0.79±0.43 D（p < 0.001）。圆锥角膜组、亚临床圆锥角膜组和对照组的TD平均大小分别为9.04±8.08、2.69±2.42和0.89±(0.50 D（p < 0.001）。发现ORA（截断点：1.21 D，敏感性83.7%，特异性87.1%）和TD（截断点：1.64 D，敏感性93.3%，特异性92.1%）在检测圆锥角膜方面具有良好的诊断性能。这些参数检测亚临床圆锥角膜的诊断能力更有限（ORA：截断值1.17 D，敏感性60.0%，特异性84.2%；TD：截断值1.29 D，敏感性80.0%，特异性80.2%）。
矢量参数ORA和TD能够在圆锥角膜和健康角膜之间进行高精度的区分。对于亚临床圆锥角膜的检测，似乎只有TD是有效的。
