Módis László, Németh Gábor, Szalai Eszter, Flaskó Zsuzsa, Seitz Berthold
Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary.
Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc 3526, Hungary.
Int J Ophthalmol. 2017 Nov 18;10(11):1686-1692. doi: 10.18240/ijo.2017.11.08. eCollection 2017.
To evaluate the anterior and posterior corneal surfaces using scanning-slit topography and to determine the diagnostic ability of the measured corneal parameters in keratoconus.
Orbscan II measurements were taken in 39 keratoconic corneas previously diagnosed by corneal topography and in 39 healthy eyes. The central minimum, maximum, and astigmatic simulated keratometry (K) and anterior axial power values were determined. Spherical and cylindrical mean power diopters were obtained at the central and at the steepest point of the cornea both on anterior and on posterior mean power maps. Pachymetry evaluations were taken at the center and paracentrally in the 3 mm zone from the center at a location of every 45 degrees. Receiver operating characteristic (ROC) analysis was used to determine the best cut-off values and to evaluate the utility of the measured parameters in identifying patients with keratoconus.
The minimum, maximum and astigmatic simulated K readings were 44.80±3.06 D, 47.17±3.67 D and 2.42±1.84 D respectively in keratoconus patients and these values differed significantly (<0.0001 for all comparisons) from healthy subjects. For all pachymetry measurements and for anterior and posterior mean power values significant differences were found between the two groups. Moreover, anterior central cylindrical power had the best discrimination ability (area under the ROC curve=0.948).
The results suggest that scanning-slit topography and pachymetry are accurate methods both for keratoconus screening and for confirmation of the diagnosis.
使用扫描裂隙地形图评估角膜前后表面,并确定所测角膜参数在圆锥角膜诊断中的能力。
对39只先前经角膜地形图诊断为圆锥角膜的角膜以及39只健康眼进行Orbscan II测量。确定中央最小、最大和散光模拟角膜曲率(K)以及前表面轴向屈光力值。在前、后平均屈光力图上,在角膜中央和最陡点获取球镜和柱镜平均屈光度数。在角膜中央以及距中央3mm区域内每45度位置处进行角膜厚度测量评估。采用受试者工作特征(ROC)分析确定最佳截断值,并评估所测参数在识别圆锥角膜患者中的效用。
圆锥角膜患者的最小、最大和散光模拟K读数分别为44.80±3.06D、47.17±3.67D和2.42±1.84D,这些值与健康受试者相比差异显著(所有比较均P<0.0001)。对于所有角膜厚度测量以及前后平均屈光力值,两组之间均存在显著差异。此外,前表面中央柱镜屈光力具有最佳鉴别能力(ROC曲线下面积=0.948)。
结果表明,扫描裂隙地形图和角膜厚度测量是圆锥角膜筛查和诊断确认的准确方法。