Department of Ophthalmology, Ningbo First Hospital, No. 59, Liuting Street, Ningbo 315010, Zhejiang, China.
Department of Ophthalmology, Xiaoshan Hospital Affiliated to Hangzhou Normal University, No. 728, Yucai North Road, Xiaoshan District, Hangzhou 311002, Zhejiang, China.
Contrast Media Mol Imaging. 2022 May 16;2022:6370791. doi: 10.1155/2022/6370791. eCollection 2022.
To explore the clinical value of Pentacam anterior segment analyzer in differential diagnosis of high myopia astigmatism and subclinical keratoconus in adolescents. The study included 100 teenagers with ophthalmic diseases treated at our hospital between July 2015 and August 2021, including 58 individuals with simple high myopia astigmatism (73 eyes in the simple high myopia astigmatism group) and 42 teenagers with subclinical keratoconus (51 eyes in the subclinical keratoconus group). The corneal parameters of the two groups were measured with a Pentacam anterior segment analyzer, and we compared the thinnest corneal thickness, anterior (posterior) vertex height of the thinnest point of the cornea, index of vertical asymmetry (IVA), index of height descent (IHD), and the average corneal pachymetric progression index. The receiver operating characteristic curve (ROC) was drawn to evaluate the value of various parameters and combined diagnostic factor Y in the differential diagnosis of high myopia astigmatism and subclinical keratoconus. The thinnest region of the cornea in the subclinical keratoconus group was less than that in the simple high myopia astigmatism group, while the anterior (posterior) vertex height of the thinnest point of the cornea, index of vertical asymmetry (IVA), index of height decentration (IHD), and average corneal pachymetric progression index were higher than those in the simple high myopia astigmatism group ( < 0.05). For the differential diagnosis of high myopia astigmatism and subclinical keratoconus, the combined diagnostic factor Y, anterior (posterior) vertex height, IVA, IHD, and mean corneal progression index were 0.808, 0.833, 0.868, 0.847, 0.684, and 0.926 ( < 0.05). The AUC of the combined diagnostic factory was the largest, which was significantly different from that of the anterior vertex height of the thinnest point of the cornea ( = 3.280), the posterior vertex height of the thinnest point of the cornea ( = 3.205), IVA ( = 2.764), IHD ( = 2.237), and the average corneal progression index ( = 4.125) ( < 0.05). Using the Pentacam anterior segment analyzer, differential diagnoses can be made for high myopia, astigmatism, and subclinical keratoconus.
目的 探讨 Pentacam 眼前节分析仪在青少年高度近视散光与亚临床圆锥角膜鉴别诊断中的临床价值。方法 选取我院 2015 年 7 月至 2021 年 8 月收治的眼科疾病青少年患者 100 例为研究对象，其中单纯高度近视散光患者 58 例（73 眼，单纯高度近视散光组），亚临床圆锥角膜患者 42 例（51 眼，亚临床圆锥角膜组）。采用 Pentacam 眼前节分析仪测量两组患者的角膜参数，比较两组患者的最薄角膜厚度、角膜最薄点前（后）顶点高度、垂直不对称指数（IVA）、高度离散指数（IHD）、角膜平均厚度进展指数。绘制受试者工作特征曲线（ROC）评价各参数及联合诊断因子 Y 在鉴别诊断高度近视散光与亚临床圆锥角膜中的价值。结果 亚临床圆锥角膜组患者的角膜最薄区小于单纯高度近视散光组，而角膜最薄点前（后）顶点高度、IVA、IHD、角膜平均厚度进展指数均高于单纯高度近视散光组（ < 0.05）。鉴别诊断高度近视散光与亚临床圆锥角膜时，联合诊断因子 Y、角膜最薄点前顶点高度、IVA、IHD、角膜平均厚度进展指数的曲线下面积分别为 0.808、0.833、0.868、0.847、0.684、0.926（ < 0.05），联合诊断因子 Y 的 AUC 最大，与角膜最薄点前顶点高度（ = 3.280）、角膜最薄点后顶点高度（ = 3.205）、IVA（ = 2.764）、IHD（ = 2.237）、角膜平均厚度进展指数（ = 4.125）比较差异均有统计学意义（ < 0.05）。结论 使用 Pentacam 眼前节分析仪可对高度近视、散光、亚临床圆锥角膜进行鉴别诊断。
