Montreal University School of Optometry, Montreal, QC, Canada.
Eye Contact Lens. 2021 May 1;47(5):295-300. doi: 10.1097/ICL.0000000000000750.
The purpose of this study was to evaluate the change in Bruch membrane opening minimum rim width (BMO-MRW) during scleral lens (SL) wear.
Twenty young white subjects were enrolled (10 women and 10 men); preliminary evaluation consisted of serial measurements of intraocular pressure (IOP) using a dynamic noncontact tonometer (Corvis, Oculus), which also yielded a corneal biomechanical index and central corneal thickness, and BMO-MRW using optical coherence tomography imaging (OCT) imaging (Spectralis, Heidelberg) through 6 hrs to establish normative diurnal curves. The next day, participants were fitted with a 16-mm SL on one eye, and OCT measurements were repeated over the same time span. Statistical analysis was carried out with a two-way analysis of variance. Multiple linear regressions were used to identify significant associations.
The average diurnal variation for BMO-MRW without lenses was -4.65 μm (95% confidence interval [CI], 0.52-8.77) after 6 hours, whereas it decreased by 8 μm (95% CI, 3.87-12.12; P<0.001) after 6 hours of SL wear. The difference between variations after 6 hours was then -3.35 μm (P=0.029). Variation of the BMO-MRW did not significantly correlate with corneal rigidity (CR), central corneal thickness (CCT), and refractive error (r=-0.224, -0.054 and -0.085, respectively).
Scleral lens wear induces a statistically significant decrease in BMO-MRW that could potentially be attributed to a change in IOP. The change in BMO-MRW was not affected by CR, CCT, or refractive error. Further studies are needed to better understand the significance of the observed changes at the optic nerve head during scleral lens wear.
本研究旨在评估巩膜镜（SL）佩戴过程中，Bruch 膜开口最小边缘宽度（BMO-MRW）的变化。
共纳入 20 名年轻白种人受试者（10 名女性，10 名男性）；初步评估包括使用动态非接触眼压计（Corvis，Oculus）连续测量眼压（IOP），该仪器还提供角膜生物力学指数和中央角膜厚度，以及使用光学相干断层扫描成像（OCT）（Spectralis，Heidelberg）测量 BMO-MRW，时间跨度为 6 小时，以建立正常的日间曲线。次日，一只眼佩戴 16mm SL，同时在相同时间跨度内重复 OCT 测量。采用双向方差分析进行统计学分析。采用多元线性回归来识别显著关联。
无镜片时，BMO-MRW 的平均日间变化为 6 小时时为-4.65μm（95%置信区间 [CI]，0.52-8.77），而佩戴 SL 6 小时后减少了 8μm（95%CI，3.87-12.12；P<0.001）。6 小时后，两种变化之间的差异为-3.35μm（P=0.029）。BMO-MRW 的变化与角膜刚性（CR）、中央角膜厚度（CCT）和屈光不正无显著相关性（r=-0.224、-0.054 和-0.085）。
巩膜镜佩戴会导致 BMO-MRW 出现统计学上的显著下降，这可能归因于 IOP 的变化。BMO-MRW 的变化不受 CR、CCT 或屈光不正的影响。需要进一步研究以更好地理解在巩膜镜佩戴过程中视神经头观察到的变化的意义。
