Yang Xiao-Long, Wang Yun, Luo Bao-Gen, Xu Yue, Zhang Xiao-Feng
Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China.
Int J Ophthalmol. 2021 Jan 18;14(1):89-96. doi: 10.18240/ijo.2021.01.13. eCollection 2021.
To explore the significance of corneal epithelial thickness analysis in diagnosing early keratoconus.
There were 26 clinical keratoconus, 21 forme fruste keratoconus, 40 high corneal astigmatism (ΔK) and 40 low ΔK eyes involved in the study. Fourier-domain optical coherence tomography was used to measure the corneal epithelial thickness of four groups. The morphological features of topographic map and the thickness of corneal epithelial thinnest point were analyzed. The distribution curve of corneal epithelial thickness at 45°, 90°, and 135° axial directions that are through the pupil center was also analyzed. One-way ANOVA was performed to compare the data.
The topographic map of forme fruste keratoconus corneal epithelial thickness was uniformity shape; crater shape existed only in clinical keratoconus group; and central island shape mainly existed in high ΔK group. The thinnest point of corneal epithelial thickness of forme fruste keratoconus group was significantly lower than that of low ΔK group (=0.022). The thickness of corneal epithelium in the forme fruste keratoconus at 90° was thinner than that in the low astigmatism group at -1, and -2 mm points ( =0.015, =0.036).
The analysis of the thinnest point in forme fruste keratoconus corneal epithelium appears earlier than corneal epithelial remodeling. The topographic map of corneal epithelium in high ΔK eyes appears in central island shape, and can be used for the differential diagnosis of early keratoconus.
探讨角膜上皮厚度分析在早期圆锥角膜诊断中的意义。
本研究纳入26例临床圆锥角膜、21例顿挫型圆锥角膜、40例高角膜散光(ΔK)和40例低ΔK眼。采用傅里叶域光学相干断层扫描测量四组的角膜上皮厚度。分析地形图的形态特征及角膜上皮最薄点的厚度。还分析了通过瞳孔中心的45°、90°和135°轴向的角膜上皮厚度分布曲线。采用单因素方差分析比较数据。
顿挫型圆锥角膜角膜上皮厚度地形图呈均匀形;火山口形仅存在于临床圆锥角膜组;中央岛形主要存在于高ΔK组。顿挫型圆锥角膜组角膜上皮最薄点显著低于低ΔK组(=0.022)。顿挫型圆锥角膜90°处角膜上皮厚度在-1和-2mm点处比低散光组薄(=0.015,=0.036)。
顿挫型圆锥角膜角膜上皮最薄点分析比角膜上皮重塑出现更早。高ΔK眼角膜上皮地形图呈中央岛形,可用于早期圆锥角膜的鉴别诊断。