J Pediatr Ophthalmol Strabismus. 2021 Jan 1;58(1):28-33. doi: 10.3928/01913913-20201007-01.
To investigate the effect of the gaze fixation position on measurement of the limbus and extraocular muscle (EOM) insertion site distance using anterior segment optical coherence tomography (AS-OCT).
Patients undergoing horizontal EOM surgeries were enrolled in this prospective experimental study. The distance between the angle recess and the muscle insertion site was measured using AS-OCT while patients fixed their gaze laterally or medially at inner or outer gaze fixation. The distance between the limbus and muscle insertion was intraoperatively measured using calipers.
A total of 46 lateral rectus muscles and 36 medial rectus muscles of 44 patients were evaluated. Significant differences were observed between intra-operative measurements (6.3 ± 0.7 mm) and AS-OCT measurements (5.8 ± 0.7 mm) for the lateral rectus muscle at inner gaze fixation (P = .0017) and medial rectus muscle at outer gaze fixation (P = .0003); no difference was observed when the lateral rectus (6.4 ± 0.5 mm) and medial rectus (4.9 ± 0.6 mm) muscles were measured at outer and inner gaze fixation, respectively. Bland-Altman plots showed better consistency at outer gaze fixation than at inner gaze fixation for the lateral rectus muscle; the opposite was observed for the medial rectus muscle. More than 80% of the AS-OCT measurements were within 1 mm of the intraoperative measurements at outer gaze fixation for the lateral rectus muscle and inner gaze fixation for the medial rectus muscle.
Gaze fixation at outer gaze fixation for the lateral rectus muscle and inner gaze fixation for the medial rectus muscle was an appropriate technique to assess limbus and EOM insertion using AS-OCT. [J Pediatr Ophthalmol Strabismus. 2021;58(1):28-33.].
研究前节光学相干断层扫描（AS-OCT）中注视固定位置对测量角膜缘和眼外肌（EOM）插入点距离的影响。
本前瞻性实验研究纳入了接受水平 EOM 手术的患者。当患者内或外注视固定于内或外侧时，使用 AS-OCT 测量角巩膜缘与肌肉插入点之间的距离。术中使用卡尺测量角膜缘与肌肉插入点之间的距离。
共评估了 44 例患者的 46 条外直肌和 36 条内直肌。在外直肌内注视时，术中测量值（6.3 ± 0.7 mm）与 AS-OCT 测量值（5.8 ± 0.7 mm）之间存在显著差异（P =.0017），在外直肌外注视时，内直肌术中测量值（4.9 ± 0.6 mm）与 AS-OCT 测量值（5.8 ± 0.7 mm）之间存在显著差异（P =.0003）；在外直肌和内直肌外注视时，分别观察到外直肌（6.4 ± 0.5 mm）和内直肌（4.9 ± 0.6 mm）之间无差异。Bland-Altman 图显示，在外直肌外注视时，AS-OCT 测量值的一致性优于内注视时；对于内直肌，情况则相反。在外直肌外注视时，超过 80%的 AS-OCT 测量值与术中测量值相差 1 mm 以内，而在内直肌内注视时则相差 1 mm 以内。
在外直肌外注视和内直肌内注视时，注视固定是使用 AS-OCT 评估角膜缘和 EOM 插入的一种合适技术。
