正常眼、顿挫型圆锥角膜眼和圆锥角膜眼中角膜动态与断层分析的比较

Comparison of Corneal Dynamic and Tomographic Analysis in Normal, Forme Fruste Keratoconic, and Keratoconic Eyes.

作者信息

Wang Yu Meng, Chan Tommy C Y, Yu Marco, Jhanji Vishal

出版信息

J Refract Surg. 2017 Sep 1;33(9):632-638. doi: 10.3928/1081597X-20170621-09.

DOI:10.3928/1081597X-20170621-09

PMID:28880339

Abstract

PURPOSE

To investigate and compare the diagnostic ability of corneal tomography and dynamic corneal response to differentiate between normal eyes and those with forme fruste keratoconus and keratoconus.

METHODS

Corneal tomography was performed using Pentacam (Pentacam HR; Oculus Optikgeräte, Wetzlar, Germany). Corneal deformation response was captured via Corvis ST (Optikgeräte) using a beta version of Corvis software. Classification analysis between normal eyes and eyes with forme fruste keratoconus and between normal and keratoconic eyes was evaluated using receiver operating characteristic curves. The area under the ROC curve (AUC) and partial AUC (pAUC) for each classifying parameter were compared.

RESULTS

Twenty-one patients with forme fruste keratoconus in one eye and clinically evident keratoconus in the fellow eye and 38 normal individuals were recruited. Overall, 21 eyes with forme fruste keratoconus and 18 eyes with keratoconus were compared with 73 normal eyes. The mean age of the participants was comparable between groups. Comparative analysis between Pentacam and Corvis ST parameters showed significantly lower AUC and pAUC for Corvis ST parameters in differentiating keratoconic from normal eyes (P ≥ .049). However, comparable AUC and pAUC was observed between the Corvis Biomechanical Index (AUC = 0.785; pAUC = 0.079) and D value of the Belin/Ambrósio Enhanced Ectasia Display (AUC = 0.757; pAUC = 0.068) (P ≥ .477) for detection of forme fruste keratoconus with sensitivities of 63.2% and 52.6%, given a common specificity of 80.3%.

CONCLUSIONS

The current study showed the feasibility of use of non-tomographical parameters obtained from the Corvis ST for differentiating normal eyes and those with forme fruste keratoconus and keratoconus. The diagnostic ability of the Corvis ST was comparable to that of the Pentacam for differentiating normal eyes and eyes with forme fruste keratoconus. [J Refract Surg. 2017;33(9):632-638.].

摘要

目的

研究并比较角膜地形图和动态角膜反应在鉴别正常眼与顿挫型圆锥角膜及圆锥角膜患者方面的诊断能力。

方法

使用Pentacam（Pentacam HR；德国韦茨拉尔Oculus Optikgeräte公司）进行角膜地形图检查。通过Corvis ST（Optikgeräte公司），使用Corvis软件的测试版采集角膜变形反应。利用受试者工作特征曲线评估正常眼与顿挫型圆锥角膜患眼之间以及正常眼与圆锥角膜患眼之间的分类分析。比较每个分类参数的ROC曲线下面积（AUC）和部分AUC（pAUC）。

结果

招募了21例单眼患有顿挫型圆锥角膜且对侧眼有临床明显圆锥角膜的患者以及38名正常个体。总体而言，将21只患有顿挫型圆锥角膜的眼和18只患有圆锥角膜的眼与73只正常眼进行比较。各组参与者的平均年龄相当。Pentacam和Corvis ST参数之间的比较分析显示，在区分圆锥角膜患眼与正常眼时，Corvis ST参数的AUC和pAUC显著更低（P≥0.049）。然而，在检测顿挫型圆锥角膜时，观察到Corvis生物力学指数（AUC = 0.785；pAUC = 0.079）和Belin/Ambrósio增强型扩张显示的D值（AUC = 0.757；pAUC = 0.068）之间的AUC和pAUC相当（P≥0.477），敏感性分别为63.2%和52.6%，共同特异性为80.3%。