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原发性先天性青光眼患者的角膜密度测定和生物力学特性。

Corneal densitometry and biomechanical properties in patients with primary congenital glaucoma.

机构信息

Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain; Hospital Universitario Quirónsalud Madrid, Madrid, Spain.

Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain.

出版信息

Can J Ophthalmol. 2021 Dec;56(6):364-370. doi: 10.1016/j.jcjo.2021.01.009. Epub 2021 Feb 10.

Abstract

OBJECTIVE

To describe corneal densitometry, topographic measurements, and biomechanical properties in patients with primary congenital glaucoma (PCG) and healthy patients. To examine correlations between variables and determine their glaucoma diagnostic capacity.

METHODS

This was a cross-sectional, case-control study conducted in 50 eyes of 50 patients with PCG (G1) and 40 eyes of 40 healthy patients (G2). The variables determined in each participant were: intraocular pressure, best corrected visual acuity (BCVA), corneal densitometry, topographic data using the Pentacam HR-Scheimpflug imaging system (Oculus Optikgerate GmbH, Wetzlar, Germany), and corneal hysteresis (CH) and corneal resistance factor (CRF) using the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Depew, NY).

RESULTS

Overall densitometry was significatively higher in the PCG group (G1: 17.94 ± 4.99 vs G2: 13.25 ± 1.96, p < 0.001). CH (G1: 8.02 ± 11.35 vs G2: 11.35 ± 1.42, p < 0.001) and CRF (G1: 9.48 ± 2.83 vs G2: 10.77 ± 1.34, p < 0.001) were lower in the glaucoma group. Mean posterior, central, and anterior elevation and mean keratometry were higher in G1 (p < 0.05). In the PCG group, overall densitometry showed significant correlation with CH (r = -0.321, p = 0.028) and with BCVA (r = -0.498, p = 0.002). AUCs (areas under the curve) for CH and overall densitometry were high (0.839 and 0.899 respectively) and the best overall densitometry; CH and CRF cutoffs were 14.0, 9.3 and 9.2 respectively.

CONCLUSION

Densitometry is increased, and biomechanical corneal properties are decreased in patients with PCG. Densitometry and visual acuity showed a negative and significant correlation, so this measurement could be used as an indirect parameter of BCVA in the clinical practice.

摘要

目的

描述原发性先天性青光眼(PCG)患者和健康患者的角膜密度计、地形测量和生物力学特性。检查变量之间的相关性,并确定它们的青光眼诊断能力。

方法

这是一项横断面、病例对照研究,纳入了 50 例 PCG 患者(G1 组)的 50 只眼和 40 例健康患者(G2 组)的 40 只眼。在每个参与者中确定的变量为:眼压、最佳矫正视力(BCVA)、角膜密度计、Pentacam HR-Scheimpflug 成像系统(德国 Oculus Optikgerate GmbH)的地形数据,以及眼反应分析仪(美国纽约州迪堡的 Reichert Ophthalmic Instruments)的角膜滞后(CH)和角膜阻力因子(CRF)。

结果

PCG 组的总体密度值明显更高(G1 组:17.94 ± 4.99 vs G2 组:13.25 ± 1.96,p < 0.001)。CH(G1 组:8.02 ± 11.35 vs G2 组:11.35 ± 1.42,p < 0.001)和 CRF(G1 组:9.48 ± 2.83 vs G2 组:10.77 ± 1.34,p < 0.001)在青光眼组中较低。G1 组的平均后、中央和前高以及平均角膜曲率较高(p < 0.05)。在 PCG 组中,总体密度与 CH(r = -0.321,p = 0.028)和 BCVA(r = -0.498,p = 0.002)呈显著相关性。CH 和总体密度的 AUC(曲线下面积)均较高(分别为 0.839 和 0.899),且最佳总体密度;CH 和 CRF 的截断值分别为 14.0、9.3 和 9.2。

结论

PCG 患者的角膜密度增加,生物力学角膜特性降低。密度计和视力显示出负相关和显著相关性,因此该测量值可在临床实践中作为 BCVA 的间接参数。

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