眼压对青光眼患者角膜变形变量进行标准化处理的诊断效能

Diagnostic Efficacy of Normalization of Corneal Deformation Variables by the Intraocular Pressure in Glaucomatous Eyes.

作者信息

Tejwani Sushma, Devi Sathi, Dinakaran Shoruba, Shetty Rohit, Meshram Priti, Francis Mathew, Sinha Roy Abhijit

机构信息

Glaucoma and Ocular Hypertension Division Narayana Nethralaya, India.

Vice-Chairman, Narayana Nethralaya, India.

出版信息

Invest Ophthalmol Vis Sci. 2016 Mar;57(3):1082-6. doi: 10.1167/iovs.15-18569.

DOI:10.1167/iovs.15-18569

PMID:26968738

Abstract

PURPOSE

To analyze the diagnostic efficacy of normalization of corneal deformation variables by the IOP in healthy, primary-angle closure (PACG), and primary open angle glaucoma (POAG) patients.

METHODS

Fifty-nine healthy, 83 POAG, and 57 PACG eyes, matched for age and pachymetry, were included in a prospective, observational, cross-sectional study. Goldmann applanation tonometry (GAT-IOP), Corvis-ST IOP, IOPg (Goldmann correlated), and IOPcc (cornea compensated) from the ocular response analyzer were acquired. Corneal hysteresis (CH) and corneal resistance factor (CRF) from the ORA, and deformation amplitude (DA) from Corvis-ST were analyzed. Further, ratios of CH, CRF, and DA to IOP were assessed among the groups and defined as new variables (e.g., ratio [CH, IOPcc] was the ratio of CH to IOPcc).

RESULTS

Goldmann applanation tonometry-IOP, IOPcc, and IOPg of PACG and POAG eyes were significantly higher than normal (P < 0.05). Corvis-ST IOP of healthy eyes was similar to POAG (P > 0.05) but lower than PACG (P = 0.02). Corneal hysteresis and CRF of PACG and POAG were significantly lower than normal (P < 0.0001). The ratio (CH, IOPcc), ratio (CRF, IOPcc), and ratio (DA, IOPcc) of healthy eyes were significantly higher than those of PACG and POAG eyes (P < 0.0001). The sensitivity and specificity of ratio (CRF, IOPcc) and ratio (DA, IOPcc) was significantly better than CRF and DA alone in PACG eyes (P < 0.001). However in POAG, only the sensitivity and specificity of ratio (DA, IOPcc) was significantly better than DA alone (P < 0.001).

CONCLUSIONS

Presence of glaucoma may be indicated better by ratio variables than by CH, CRF, or DA alone.

摘要

目的

分析眼压对健康人、原发性闭角型青光眼（PACG）和原发性开角型青光眼（POAG）患者角膜变形变量正常化的诊断效能。

方法

纳入59只健康眼、83只POAG眼和57只PACG眼，这些眼睛在年龄和角膜厚度测量方面进行了匹配，参与一项前瞻性、观察性横断面研究。获取了Goldmann压平眼压计测量的眼压（GAT-IOP）、Corvis-ST眼压、与Goldmann相关的眼压（IOPg）以及眼反应分析仪的角膜补偿眼压（IOPcc）。分析了眼反应分析仪测量的角膜滞后（CH）和角膜阻力因子（CRF），以及Corvis-ST测量的变形幅度（DA）。此外，评估了各组中CH、CRF和DA与眼压的比值，并将其定义为新变量（例如，比值[CH，IOPcc]是CH与IOPcc的比值）。

结果

PACG和POAG眼的Goldmann压平眼压计测量的眼压、IOPcc和IOPg显著高于正常水平（P < 0.05）。健康眼的Corvis-ST眼压与POAG眼相似（P > 0.05），但低于PACG眼（P = 0.02）。PACG和POAG眼的角膜滞后和CRF显著低于正常水平（P < 0.0001）。健康眼的比值（CH，IOPcc）、比值（CRF，IOPcc）和比值（DA，IOPcc）显著高于PACG和POAG眼（P < 0.0001）。在PACG眼中，比值（CRF，IOPcc）和比值（DA，IOPcc）的敏感性和特异性显著优于单独的CRF和DA（P < 0.001）。然而在POAG中，只有比值（DA，IOPcc）的敏感性和特异性显著优于单独的DA（P < 0.001）。