Zhang Y, Chen Y G, Yang H Y, Xia Y J, Zhao R
Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China.
Zhonghua Yan Ke Za Zhi. 2018 Jan 11;54(1):33-38. doi: 10.3760/cma.j.issn.0412-4081.2018.01.007.
To evaluate the role of Sirius combined topography and tomography system in screening for suspect keratoconus among the corneal refractive surgery candidates. Retrospective case series study. Eight hundred and sixteen consecutive ametropic patients (1 632 eyes) who underwent routine examinations before corneal refractive surgery at Peking University Third Hospital from January 2016 to September 2016 were reviewed. All the cases were analyzed with Sirius combined topography and tomography system. Fifty-nine eyes of 37 patients, aged (28.9±7.4) years, classified as suspect keratoconus by the system were enrolled in the suspect group, including 25 females (40 eyes) and 12 males (19 eyes). A random eye of the first 59 patients, aged (27.1±6.4)years, whose both eyes were classified as normal by Sirius system were enrolled in the control group, including 38 females and 21 males. The corneal anterior surface, posterior surface and minimum thickness data of the suspect group were analyzed and then compared with the control group. The classified results were further verified by Pentacam system. Independent-samples test and Mann-Whitney test were applied to analyze the normal distribution and non-normal distribution data respectively. The medians of anterior surface and posterior surface symmetry index and Baiocchi Calossi Versaci index of anterior surface and posterior surface of the suspect group were 0.84, 0.22, 0.58 and 0.51 D, and that of the control group were 0.05, 0.04, 0.09 and 0.06 D, and the differences were of statistical significance (18.764, -8.351, -12.248, -10.709, 0.01). Mean corneal minimum thickness data of the suspect group were (504.4±30.0)μm, and that of the control group were (541.2±32.1)μm, the differences were of statistical significance (6.408, 0.01). In the suspect group, the eyes related with suspect or abnormal corneal anterior indices accounted for 47.5% (28/59), the eyes related with suspect or abnormal corneal posterior indices accounted for 55.9% (33/59), and the eyes related with suspect or abnormal corneal minimum thickness accounted for 40.7% (24/59). In the suspect group, 45 eyes (76.3%) were classified as suspect or abnormal according to the overall variance index "D" by Belin-Ambrósio Display (BAD) of the Pentacam system, and the other 14 eyes exhibited at least one abnormal index related with keratoconus. Sirius 3D combined topography and tomography and its integral automatic classification system is capable to screen out the suspect keratoconus simply and effectively. These indices maybe arranged in descending order in terms of the sensitivity as corneal posterior surface, followed by corneal anterior surface and then corneal thinnest point thickness. .
评估Sirius综合地形和断层扫描系统在角膜屈光手术候选者中筛查疑似圆锥角膜的作用。回顾性病例系列研究。对2016年1月至2016年9月在北京大学第三医院接受角膜屈光手术常规检查的816例连续屈光不正患者（1632只眼）进行了回顾。所有病例均采用Sirius综合地形和断层扫描系统进行分析。该系统分类为疑似圆锥角膜的37例患者的59只眼纳入疑似组，年龄（28.9±7.4）岁，其中女性25例（40只眼），男性12例（19只眼）。Sirius系统将双眼分类为正常的前59例患者中，随机选取一只眼纳入对照组，年龄（27.1±6.4）岁，其中女性38例，男性21例。分析疑似组的角膜前表面、后表面和最小厚度数据，然后与对照组进行比较。分类结果通过Pentacam系统进一步验证。分别应用独立样本t检验和Mann-Whitney U检验分析正态分布和非正态分布数据。疑似组角膜前表面和后表面对称指数以及前表面和后表面的Baiocchi Calossi Versaci指数的中位数分别为0.84 D、0.22 D、0.58 D和0.51 D，对照组分别为0.05 D、0.04 D、0.09 D和0.06 D，差异具有统计学意义（18.764、-8.35l、-12.248、-10.709，P<0.01）。疑似组角膜平均最小厚度数据为（504.4±30.0）μm，对照组为（541.2±32.1）μm，差异具有统计学意义（6.408，P<0.01）。在疑似组中，与疑似或异常角膜前指数相关的眼占47.5%（28/59），与疑似或异常角膜后指数相关的眼占55.9%（33/59），与疑似或异常角膜最小厚度相关的眼占40.7%（24/59）。在疑似组中，根据Pentacam系统的Belin-Ambrósio Display（BAD）整体方差指数“D”，45只眼（76.3%）被分类为疑似或异常，另外14只眼表现出至少一项与圆锥角膜相关的异常指数。Sirius 3D综合地形和断层扫描及其整体自动分类系统能够简单有效地筛查出疑似圆锥角膜。这些指标按敏感性从高到低排列可能依次为角膜后表面、角膜前表面、角膜最薄点厚度。
