Department of Clinical Sciences, Ophthalmology, Lund University, Skåne University Hospital, Kioskgatan 1, 222 85, Lund, Sweden.
Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
Sci Rep. 2021 Aug 6;11(1):16037. doi: 10.1038/s41598-021-95503-8.
The progression of keratoconus is commonly determined by comparing the results of corneal tomographic measurements on different occasions. However, investigations on the repeatability of measurements are commonly performed within the same day, thus not taking the inter-day variation into account. The effect of keratoconus disease severity on the measurement error is also seldom considered. In this post hoc investigation, the parameters A, B and C in the Belin ABCD Progression Display were evaluated in relation to disease severity in intra-day and inter-day measurements. Four consecutive measurements were performed on 61 patients with keratoconus on the same day (intra-day). In another cohort, four consecutive measurements were obtained and then repeated 3 days later in 25 patients with keratoconus and 25 healthy controls (inter-day). The results suggest that the diagnosis of disease progression would benefit from inter-day measurements, and the stratification of the parameters A and C according to disease severity. It is also recommended that tomographic systems such as the Pentacam HR be modified to allow the comparison of both single measurements and the mean of replicate measurements of the parameters used in the assessment of progression of keratoconus.
圆锥角膜的进展通常通过比较不同时间点角膜断层测量的结果来确定。然而，通常在同一天内进行测量重复性的研究，因此没有考虑到日间变化。圆锥角膜疾病严重程度对测量误差的影响也很少被考虑。在本事后调查中，评估了 Belin ABCD 进展显示中的参数 A、B 和 C 与日间和夜间测量的疾病严重程度之间的关系。在同 61 例圆锥角膜患者中进行了 4 次连续测量（日间）。在另一队列中，在 25 例圆锥角膜患者和 25 例健康对照组中进行了 4 次连续测量，然后在 3 天后重复测量（日间）。结果表明，疾病进展的诊断将受益于日间测量，以及根据疾病严重程度对参数 A 和 C 进行分层。还建议对 Pentacam HR 等断层成像系统进行修改，以允许比较圆锥角膜进展评估中使用的单个测量值和参数重复测量的平均值。
