贝林 ABCD 进展显示比传统指标更早识别圆锥角膜进展。

Belin ABCD Progression Display Identifies Keratoconus Progression Earlier Than Conventional Metrics.

机构信息

Ophthalmology Clinic, Devrek State Hospital, Zonguldak, Turkey (O.O.).

Department of Ophthalmology, Eskişehir Osmangazi University Medical School, Eskişehir, Turkey (E.A).

出版信息

Am J Ophthalmol. 2022 Apr;236:45-52. doi: 10.1016/j.ajo.2021.10.003. Epub 2021 Oct 12.

DOI:10.1016/j.ajo.2021.10.003

PMID:34653352

Abstract

PURPOSE

To compare the progression rate and time to progression determined using the Belin ABCD Progression Display (BAPD) with conventional metrics in patients with keratoconus (KC).

DESIGN

Retrospective comparison of progression assessment.

METHODS

Patients 18 years and older and 35 years and younger with at least 1 year of follow-up and 3 Pentacam (Oculus, Inc) visits were included in the study. Progression was evaluated by selecting either the first visit or the first 2 visits individually as the baseline on the BAPD, and the red gate was used to determine progression (variability in any A, B, and C parameters ≥95% CI or any 2 parameters ≥80% CI). An increase of ≥1 diopter in corneal astigmatism and curvature parameters and a ≥2% reduction in thickness parameters constituted progressive disease.

RESULTS

Two hundred seventy-seven eyes of 155 patients were included. The 2 baseline visit criteria identified the highest progression (n = 186 [67.2%]), followed by the single baseline visit (n = 158 [57%]), minimum corneal thickness (n = 114 [41.2%]), central corneal thickness (n = 111 [40.1%]), maximum keratometry (n = 76 [27.4%]), corneal astigmatism (n = 55 [19.9%]), back mean keratometry (n = 50 [18.1%]), and front mean keratometry (n = 31 [11.2%]) criteria. The median time to progression was shortest using the single baseline visit criterion (11 months), followed by the 2 baseline visits (11.6 months), minimum corneal thickness (12.1 months), maximum keratometry (12.3 months), corneal astigmatism (14.8 months), central corneal thickness (16.6 months), back mean keratometry (18.4 months), and front mean keratometry (24.4 months) criteria. In a subgroup analysis, progression could be identified 4 to 7 months earlier with the BAPD in eyes that were also progressive for maximum keratometry and central corneal thickness.

CONCLUSIONS

BAPD detects progression at a higher rate and earlier than conventional parameters.

摘要

目的

比较使用 Belin ABCD 进展显示（BAPD）与传统指标在圆锥角膜（KC）患者中的进展率和进展时间。

设计

进展评估的回顾性比较。

方法

本研究纳入了至少有 1 年随访且有 3 次 Pentacam（Oculus，Inc.）检查的年龄在 18 岁及以上和 35 岁及以下的患者。通过在 BAPD 上单独选择第 1 次就诊或前 2 次就诊作为基线来评估进展，使用红门来确定进展（任何 A、B 和 C 参数的变异性≥95%CI 或任何 2 个参数≥80%CI）。角膜散光和曲率参数增加≥1 屈光度和厚度参数减少≥2%构成进行性疾病。

结果

本研究纳入了 155 例患者的 277 只眼。2 次基线就诊标准确定了最高的进展率（n=186[67.2%]），其次是单次基线就诊（n=158[57%]）、最小角膜厚度（n=114[41.2%]）、中央角膜厚度（n=111[40.1%]）、最大角膜曲率（n=76[27.4%]）、角膜散光（n=55[19.9%]）、后平均角膜曲率（n=50[18.1%]）和前平均角膜曲率（n=31[11.2%]）标准。使用单次基线就诊标准的中位进展时间最短（11 个月），其次是 2 次基线就诊（11.6 个月）、最小角膜厚度（12.1 个月）、最大角膜曲率（12.3 个月）、角膜散光（14.8 个月）、中央角膜厚度（16.6 个月）、后平均角膜曲率（18.4 个月）和前平均角膜曲率（24.4 个月）标准。在亚组分析中，在对最大角膜曲率和中央角膜厚度也呈进展性的眼睛中，BAPD 可提前 4 至 7 个月识别出进展。