Liu Rong-Jun, Ma Bai-Kai, Gao Yu-Fei, Liu Yi-Yun, Qi Hong
Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.
Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China.
Int J Ophthalmol. 2022 Mar 18;15(3):407-412. doi: 10.18240/ijo.2022.03.06. eCollection 2022.
To compare the wavefront aberrations and corneal surface regularity between dry eye (DE) patients and normal subjects and assess its diagnostic performance for DE measured with OPD Scan-III.
Fifty right eyes of 50 DE patients and 31 right eyes of normal subjects were included. The examinations for ocular surface including logarithm of the minimum angle of resolution best-corrected distance visual acuity (logMAR BCVA) the ocular surface disease index (OSDI), tear film break-up time (TBUT) and corneal fluorescein staining (CFS). OPD Scan-III was used to measure anterior corneal aberrations including total corneal aberrations, high order aberration (HOA), coma, trefoil, spherical aberration (SA), standard deviation of corneal power (SDP), surface regularity index (SRI) and surface asymmetry index (SAI). Statistical analysis were assessed with nonparametric tests and Spearman's correlations. All parameters were also analyzed for sensitivity, specificity, and receiver operating characteristics (ROC) curves.
Wavefront aberrations parameters including total corneal aberrations, HOA, coma, trefoil, and SA in DE group were significantly higher than those in normal group (<0.001). Corneal surface regularity parameters including SRI and SAI in DE group were significantly higher than both in normal group (<0.05). All the wavefront aberrations parameters had significant correlations with ocular surface parameters (<0.05). The logMAR BCVA had positive correlations with SAI and SRI (all <0.001). CFS scores had positive correlations with SAI and SRI (all <0.001). All the wavefront aberrations parameters showed good diagnosis sensitivity and specificity, however, the corneal regularity parameters showed only good specificity but poor sensitivity. The cut-off value selected for trefoil in diagnosis DE showed the highest area under the curve (AUC, 0.921) values as compared to the other parameters with sensitivity of 0.955 and specificity of 0.867.
Wavefront aberrations and corneal surface regularity are increased in DE patients and also correlated with ocular surface parameters. Wavefront aberrations parameters have potential to be indicators to diagnosis and monitor DE.
比较干眼（DE）患者与正常受试者的波前像差和角膜表面规则性，并评估OPD Scan-III测量DE的诊断性能。
纳入50例DE患者的50只右眼和正常受试者的31只右眼。进行眼表检查，包括最小分辨角对数最佳矫正远视力（logMAR BCVA）、眼表疾病指数（OSDI）、泪膜破裂时间（TBUT）和角膜荧光素染色（CFS）。使用OPD Scan-III测量角膜前表面像差，包括总角膜像差、高阶像差（HOA）、彗差、三叶草像差、球差（SA）、角膜屈光力标准差（SDP）、表面规则性指数（SRI）和表面不对称指数（SAI）。采用非参数检验和Spearman相关性进行统计分析。还对所有参数进行了敏感性、特异性和受试者工作特征（ROC）曲线分析。
DE组的波前像差参数，包括总角膜像差、HOA、彗差、三叶草像差和SA，均显著高于正常组（<0.001）。DE组的角膜表面规则性参数，包括SRI和SAI，均显著高于正常组（<0.05）。所有波前像差参数与眼表参数均有显著相关性（<0.05）。logMAR BCVA与SAI和SRI呈正相关（均<0.001）。CFS评分与SAI和SRI呈正相关（均<0.001）。所有波前像差参数均显示出良好的诊断敏感性和特异性，然而，角膜规则性参数仅显示出良好的特异性，但敏感性较差。与其他参数相比，诊断DE时所选的三叶草像差截断值显示出最高的曲线下面积（AUC，0.921），敏感性为0.955，特异性为0.867。
DE患者的波前像差和角膜表面规则性增加，且与眼表参数相关。波前像差参数有潜力成为诊断和监测DE的指标。
