Department of Cornea and Refractive Surgery, Vissum, Alicante, Spain; Keratoconus Unit of Vissum, Alicante, Spain; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.
Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Am J Ophthalmol. 2019 Apr;200:255-262. doi: 10.1016/j.ajo.2019.01.015. Epub 2019 Jan 26.
To evaluate intra-subject repeatability of anterior segment optical coherence tomography (AS-OCT) combined with placido disc MS-39 (CSO, Firenze, Italy) and correlate epithelial thickness measurements and the degree of visual limitation in keratoconus patients.
Reliability analysis and cross-sectional study.
Setting: Vissum, Alicante, Spain.
Total of 167 eyes, of which 107 were from keratoconus patients and 60 were healthy.
Three repeated consecutive epithelial thickness measurements were taken: central 3.0 mm and the nasal, temporal, superior, and inferior regions at 3.0-6.0 mm and 6.0-8.0 mm.
Intrasubject repeatability of epithelial indices was assessed and correlated to the degree of best-corrected visual acuity (BCVA).
The intraclass correlation coefficient was ≥0.90, indicating highly repeatable measurements for both keratoconus and healthy eyes. In multivariate analysis, epithelial indices associated with worse BCVA were as follows: thinner 3 mm central (P = .04), thicker 8 mm superior (P < .001), and thinner 8 mm inferior (P < .001). Thickness central 3 mm decreased as keratoconus grading increased (P = .002). The superior-inferior ratio at 8 mm significantly increased as keratoconus grading increased (P < .001). In multivariate analysis thinner 3 mm central (R = 6.19%, P = .04), greater superior-inferior 8 mm ratio (R = 8.37%, P = .004), greater superior-inferior 6mm ratio (R = 2.67%, P = .02), and steeper K2 (R = 21.51%, P < .001) were associated with keratoconus with a combined area under the curve of 0.92.
High repeatability of epithelial thickness measurements may be achieved in both keratoconus and healthy eyes with the MS-39. There is a significant correlation between epithelial thickness measurements and BCVA. These measurements may be of additional value in discriminating between keratoconus and healthy eyes.
评估眼前节光学相干断层扫描（AS-OCT）联合角膜地形图 MS-39（CSO，意大利佛罗伦萨）的同患者内重复性，并与圆锥角膜患者的上皮厚度测量值和视觉受限程度相关联。
可靠性分析和横断面研究。
西班牙阿利坎特的 Vissum。
共 167 只眼，其中 107 只为圆锥角膜患者，60 只为健康对照。
连续 3 次测量上皮厚度：中央 3.0mm 和鼻侧、颞侧、上侧和下侧 3.0-6.0mm 和 6.0-8.0mm 区域。
评估上皮指数的同患者内重复性，并与最佳矫正视力（BCVA）的程度相关联。
内类相关系数≥0.90，表明圆锥角膜和健康眼的测量值高度可重复。多元分析显示，与 BCVA 较差相关的上皮指数如下：中央 3mm 处更薄（P=0.04）、上侧 8mm 处更厚（P<0.001）和下侧 8mm 处更薄（P<0.001）。随着圆锥角膜分级的增加，中央 3mm 厚度减小（P=0.002）。随着圆锥角膜分级的增加，8mm 处的上下比显著增加（P<0.001）。多元分析显示，中央 3mm 更薄（R=6.19%，P=0.04）、上下 8mm 比更大（R=8.37%，P=0.004）、上下 6mm 比更大（R=2.67%，P=0.02）和 K2 更陡峭（R=21.51%，P<0.001）与圆锥角膜相关，曲线下面积为 0.92。
角膜地形图 MS-39 可在圆锥角膜和健康眼中实现上皮厚度测量的高度可重复性。上皮厚度测量值与 BCVA 之间存在显著相关性。这些测量值在区分圆锥角膜和健康眼方面可能具有额外的价值。
