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角膜生物力学特性对不同类型格雷夫斯眼眶病眼压测量的影响。

Influence of corneal biomechanical properties on intraocular pressure measurement in different types of Graves’ orbitopathy.

作者信息

Pérez-López Marta, Ting Darren S J, Lanzagorta-Aresti Aitor, Montolio-Marzo Santiago, Davó-Cabrera Juan, Cid-García Isabel

机构信息

Ophthalmology Department, 16273Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Academic Ophthalmology, School of Medicine, 6123University of Nottingham, Nottingham, UK.

出版信息

Eur J Ophthalmol. 2023 Jan;33(1):567-573. doi: 10.1177/11206721221124655. Epub 2022 Sep 4.

Abstract

BACKGROUND/AIMS: To compare the ocular biomechanical properties of inactive Grave's orbitopathy (GO) patients and healthy subjects and to evaluate the influence of severity and phenotype of GO on these parameters.

METHODS

This was a cross-sectional study. All included inactive GO patients and healthy controls underwent complete ocular examination, including Goldman applanation tonometry (GAT), corneal biomechanical analysis using Ocular Response Analyser (ORA), and corneal epithelial thickness analysis using Optovue. Patients with inactive GO were classified based on the severity and orbital phenotype (predominantly myogenic or lipogenic). Comparison among groups was performed.

RESULTS

60 eyes from 30 inactive GO patients and 30 healthy eyes were examined. Corneal hysteresis (CH) was significantly lower in inactive GO patients (9.6 [p25 8.1; p75 11.2]) compared to controls (10.4 [9.8; 11.5]) ( = 0.012). In GO patients, cornea compensated intraocular pressure (IOPcc) was significantly higher than Goldman applanation tonometry IOP (IOP-GAT) ( = 0.001). A total of 13.3% GO patients were initially classified as having ocular hypertension (OHT; defined as IOP > 21 mmHg with no signs of glaucomatous optic neuropathy) based on IOP-GAT measurement. According to IOPcc, 27.8% of GO patients were classified as OHT. In GO patients, no differences were found in corneal bimechanical properties according to the disease severity or orbital phenotype.

CONCLUSIONS

CH is significantly lower in inactive GO patients compared to healthy subjects. ORA corrected IOP was significantly higher in GO patients compared to IOP-GAT. No differences in corneal biomechanical properties between mild and moderate-to-severe GO disease and between myogenic and lipogenic orbitopathy were found.

摘要

背景/目的:比较静止期格雷夫斯眼眶病(GO)患者与健康受试者的眼部生物力学特性,并评估GO的严重程度和表型对这些参数的影响。

方法

这是一项横断面研究。所有纳入的静止期GO患者和健康对照均接受了全面的眼部检查,包括Goldman压平眼压测量法(GAT)、使用眼反应分析仪(ORA)进行角膜生物力学分析以及使用Optovue进行角膜上皮厚度分析。静止期GO患者根据疾病严重程度和眼眶表型(主要是肌源性或脂肪生成性)进行分类。进行组间比较。

结果

检查了30例静止期GO患者的60只眼和30只健康对照眼。与对照组(10.4 [9.8;11.5])相比,静止期GO患者的角膜滞后(CH)显著降低(9.6 [第25百分位数8.1;第75百分位数11.2])(P = 0.012)。在GO患者中,角膜补偿眼压(IOPcc)显著高于Goldman压平眼压测量法测得的眼压(IOP - GAT)(P = 0.001)。基于IOP - GAT测量,共有13.3%的GO患者最初被分类为患有高眼压症(OHT;定义为眼压>21 mmHg且无青光眼性视神经病变迹象)。根据IOPcc,27.8%的GO患者被分类为OHT。在GO患者中,根据疾病严重程度或眼眶表型,角膜生物力学特性未发现差异。

结论

与健康受试者相比,静止期GO患者的CH显著降低。与IOP - GAT相比,GO患者中ORA校正的眼压显著更高。在轻度与中度至重度GO疾病之间以及肌源性和脂肪生成性眼眶病之间,未发现角膜生物力学特性存在差异。

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