亚临床圆锥角膜和未定型圆锥角膜的系统评价

A Systematic Review of Subclinical Keratoconus and Forme Fruste Keratoconus.

出版信息

J Refract Surg. 2020 Apr 1;36(4):270-279. doi: 10.3928/1081597X-20200212-03.

DOI:10.3928/1081597X-20200212-03

Abstract

PURPOSE

To identify the definitions used for the terms sub-clinical keratoconus and forme fruste keratoconus in published articles.

METHODS

This was a prospective, systematic literature review of the electronic database in PubMed, the Cochrane Library, and LILACS Database of all studies using the keywords "subclinical keratoconus" and/or "forme fruste keratoconus" until August 18, 2017. Two independent reviewers analyzed the data. The inclusion criteria for articles were having analyzed subclinical keratoconus or forme fruste keratoconus eyes with a sample size greater than 10 eyes; containing the definition of subclinical keratoconus or forme fruste keratoconus; and the quality of published reports was assessed using standards quality index methods. The following aspects of the selected articles were then analyzed: inclusion criteria for definition and technology used.

RESULTS

A total of 198 and 95 studies, respectively, including the definition of subclinical keratoconus and forme fruste keratoconus were collected in an initial search, of which 165 and 73 studies, respectively, were excluded. Definitions for subclinical keratoconus and forme fruste keratoconus included the criteria of having keratoconus in the fellow eye in 72.72% (24 of 33) and 77.27% (17 of 22) of the articles, respectively. A total of 96.97% (32 of 33) and 90.90% (20 of 22) of the studies used more than one parameter to define subclinical keratoconus and forme fruste keratoconus, respectively. The most common extra parameters included normal slit-lamp examination and cornea on slit-lamp biomicroscopy and inferior-superior asymmetry and/or bowtie pattern with skewed radial axes.

CONCLUSIONS

This review demonstrates the lack of unified criteria to define subclinical keratoconus and forme fruste keratoconus. According to the literature review, the most common subclinical keratoconus definition used refers to an eye with topographic signs of keratoconus and/or suspicious topographic findings under normal slit-lamp examination and keratoconus in the fellow eye and the most common forme fruste keratoconus definition refers to an eye with normal topography, normal slit-lamp examination, and keratoconus in the fellow eye. [J Refract Surg. 2020;36(4):270-279.].

摘要

目的

确定已发表文献中用于亚临床圆锥角膜和未定型圆锥角膜这两个术语的定义。

方法

这是一项针对电子数据库 PubMed、Cochrane 图书馆和 LILACS 数据库的前瞻性、系统文献综述，对所有使用关键词“亚临床圆锥角膜”和/或“未定型圆锥角膜”的研究进行了综述，检索时间截至 2017 年 8 月 18 日。两位独立的审查员对数据进行了分析。纳入研究的标准为：分析了样本量大于 10 只眼的亚临床圆锥角膜或未定型圆锥角膜眼；包含亚临床圆锥角膜或未定型圆锥角膜的定义；并使用标准质量指数方法评估已发表报告的质量。然后分析所选文章的以下方面：定义和使用技术的纳入标准。

结果

在初步搜索中，分别收集了 198 项和 95 项研究，其中包括亚临床圆锥角膜和未定型圆锥角膜的定义，分别有 165 项和 73 项研究被排除。亚临床圆锥角膜和未定型圆锥角膜的定义分别包括对侧眼存在圆锥角膜的标准，分别占 72.72%（24/33）和 77.27%（17/22）。共有 96.97%（32/33）和 90.90%（20/22）的研究分别使用了超过一个参数来定义亚临床圆锥角膜和未定型圆锥角膜。最常见的额外参数包括正常裂隙灯检查和角膜裂隙灯生物显微镜检查以及下-上不对称和/或带有倾斜放射轴的蝴蝶结样模式。

结论

本综述表明缺乏统一的标准来定义亚临床圆锥角膜和未定型圆锥角膜。根据文献综述，最常用的亚临床圆锥角膜定义是指具有角膜地形图特征的眼和/或在正常裂隙灯检查下可疑的角膜地形图表现，以及对侧眼存在圆锥角膜；最常用的未定型圆锥角膜定义是指具有正常的角膜地形、正常的裂隙灯检查和对侧眼存在圆锥角膜的眼。[J Refract Surg. 2020;36(4):270-279.]。