Zhang Y, She X X, Yu X J, Chen L F, Shen L J
The Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Zhonghua Yan Ke Za Zhi. 2016 Apr 11;52(4):263-7. doi: 10.3760/cma.j.issn.0412-4081.2016.04.006.
This study aims to compare the corneal biomechanical properties of patients with Graves'orbitopathy (GO) with normal people and analysis the correlated factors.
Retrospective case series study. 34 eyes of 20 patients (6 eyes are unilateral) diagnosed with inactive Graves' orbitopathy and 25 eyes of 14 patients (3 eyes are unilateral) diagnosed with active Graves' orbitopathy were recruited as study group. 30 eyes of 28 healthy volunteers with age and sex-matched were enrolled as control group in the affiliated eye hospital of Wenzhou medical university from December 2013 to June 2014. Central corneal thickness (CCT) measured with A ultrasound, corneal hysteresis (CH) measured with Ocular Response Analyser (ORA), corneal resistance factor (CRF), Goldman-corrected IOP value (IOPg) and Cornea-Compensated Intraocular Pressure(IOPcc) were collected. An ANONA and Kruskal-Wallis Test was used to compare the indexes mentioned above.
The mean age of inactive group was (47.3±12.8)y (23 eyes were female, 11 eyes were male), the mean age of active group was (51.9±9.6)y (16 eyes were female, 9 eyes were male) , the mean age of normal group was (47.2±10.4)y (19 eyes were female, 9 eyes were male). CH of inactive group was (9.68±1.45) mmHg, (1 mmHg=0.133 kPa), CH of active group was (9.82±1.53) mmHg, lower than the CH of (10.67±1.68) mmHg in control group, which was statistically significant different (t1=-2.51,P1=0.014,t2=-2.01,P2=0.048). IOPcc of inactive group was (17.91±3.67) mmHg, IOPcc of active group was (17.88±5.44) mmHg, which were higher than the IOPcc of (13.90±3.39) mmHg in the control group, which was statistically significant different (t1=3.76,P1=0.001;t2= 3.461,P2=0.001). There were no significant difference between study and control group in CRF, that was in inactive group (10.19±1.73)mmHg, active group (10.36±1.01)mmHg, normal group (10.08±1.40)mmHg respectively (t1=0.31,P=0.761;t2=0.69,P2=0.491). CCT of inactive group was (531.41±37.60) μm, CCT of active group is (533.52±18.88) μm, which had no statistical significant difference from the CCT of (546.25±28.84) μm in control group (t1=-1.91,P=0.059;t2=-1.52,P2=0.132). Corneal hysteresis was negatively correlated with exophthalmos, IOPg, IOPcc (Pearson=-0.279,-0.385,-0.663,P<0.05), and positively correlated with corneal central thickness and corneal resistance factor (Pearson=0.246,0.583,P<0.05) in TAO group.
Cornea hysteresis of TAO patients decreased, combined with lower ability of cornea to recover to the primary conditions when upon pressure. CH was negatively correlated with IOPg and IOPcc.(Chin J Ophthalmol, 2016, 52: 263-267).
本研究旨在比较格雷夫斯眼眶病（GO）患者与正常人的角膜生物力学特性，并分析相关因素。
回顾性病例系列研究。选取2013年12月至2014年6月在温州医科大学附属眼视光医院就诊的20例（6眼为单眼）诊断为静止期格雷夫斯眼眶病患者的34眼和14例（3眼为单眼）诊断为活动期格雷夫斯眼眶病患者的25眼作为研究组。选取28例年龄和性别匹配的健康志愿者的30眼作为对照组。采用A超测量中央角膜厚度（CCT），用眼反应分析仪（ORA）测量角膜滞后（CH）、角膜阻力因子（CRF）、Goldman校正眼压值（IOPg）和角膜补偿眼压（IOPcc）。采用方差分析和Kruskal-Wallis检验比较上述指标。
静止期组平均年龄为（47.3±12.8）岁（女性23眼，男性11眼），活动期组平均年龄为（51.9±9.6）岁（女性16眼，男性9眼），正常组平均年龄为（47.2±10.4）岁（女性19眼，男性9眼）。静止期组CH为（9.68±1.45）mmHg（1 mmHg = 0.133 kPa），活动期组CH为（9.82±1.53）mmHg，低于对照组的（10.67±1.68）mmHg，差异有统计学意义（t1=-2.51，P1 = 0.014；t2=-2.01，P2 = 0.048）。静止期组IOPcc为（17.91±3.67）mmHg，活动期组IOPcc为（17.88±5.44）mmHg，高于对照组的（13.90±3.39）mmHg，差异有统计学意义（t1 = 3.76，P1 = 0.001；t2 = 3.461，P2 = 0.001）。研究组与对照组CRF差异无统计学意义，静止期组为（10.19±1.73）mmHg，活动期组为（10.36±1.01）mmHg，正常组为（10.08±1.40）mmHg（t1 = 0.31，P = 0.761；t2 = 0.69，P2 = 0.491）。静止期组CCT为（531.41±37.60）μm，活动期组CCT为（533.52±18.88）μm，与对照组的（546.25±28.84）μm比较，差异无统计学意义（t1=-1.91，P = 0.059；t2=-1.52，P2 = 0.132）。在甲状腺相关眼病（TAO）组中，角膜滞后与眼球突出、IOPg、IOPcc呈负相关（Pearson=-0.279、-0.385、-0.663，P<0.05），与角膜中央厚度和角膜阻力因子呈正相关（Pearson = 0.246、0.583，P<0.05）。
TAO患者角膜滞后降低，且角膜在受压后恢复至初始状态的能力较低。CH与IOPg和IOPcc呈负相关。（《中华眼科杂志》，2016，52：263 - 267）
