圆锥角膜进展中 CLMI-X 参数、最大子午线 K 值和单点最大 K 值的变异性。
Variability of CLMI-X parameters, zonal Kmax, and single-point Kmax in keratoconus progression.
机构信息
Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
Department of Ophthalmology & Visual Sciences, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.
出版信息
Eye (Lond). 2023 Oct;37(15):3197-3202. doi: 10.1038/s41433-023-02476-1. Epub 2023 Mar 14.
OBJECTIVES
To compare the repeatability of Cone Location and Magnitude Index expanded (CLMI.X) parameters of 2 mm diameter zone of greatest corneal curvature (Cspot-Axi) and 1 mm diameter zone of thinnest pachmymetry (Spot-Pach) with the maximum single point keratometry (Kmax), 3 mm Zonal Kmax (Z-Kmax3), and thinnest single point pachymetry (TP) in keratoconus (KC).
METHODS
In this Comparative repeatability study, data from 36 eyes of 36 normal individuals and 72 eyes of 72 KC patients (28 eyes with ≤50.0D and 44 eyes with >50.0D Z-Kmax3) were analyzed. For each enrolled eye, imaging was done 6 times (3 consecutive acquisitions with a half hour break). For each parameter, the within-subject standard deviation (Sw) was calculated from the data of the six exams.
RESULTS
In the normal group, Cspot-Axi-Sw was different from Kmax-Sw (p = 0.0004). Also, Z-Kmax3-Sw was different from Kmax-Sw (p = 0.0297). The difference between Cspot-Axi-Sw and Z-Kmax3-Sw was statistically significant (p = 0.0482). In the KC group, Sw were significantly different between Cspot-Axi and Kmax (p < 0.0001), and between Z-Kmax3 and Kmax (p < 0.0001). In the Z-Kmax3 ≤ 50.0D subgroup, Sw were different between Cspot-Axi and Kmax (p = 0.0002). In the Z-Kmax3 > 50.0D subgroup, Sw were different between Cspot-Axi and Kmax (p < 0.0001), and between Z-Kmax3 and Kmax (p < 0.0001). Sw differences between Spot-Pach and TP were not significant in any of the study groups (all P > 0.05).
CONCLUSIONS
In the diagnosis and follow up of KC, the zonal averages of Cspot-Axi and Z-Kmax3 are more reliable than the single point Kmax. The repeatability of Spot-Pach is similar to TP and both variables should suit the purpose equally.
目的
比较角膜曲率最大点（Cspot-Axi）2mm 直径区和最薄点（Spot-Pach）1mm 直径区的圆锥角膜（KC）的 Cone Location and Magnitude Index expanded（CLMI.X）参数的重复性与最大单一点角膜曲率（Kmax）、3mm 区带 Kmax（Z-Kmax3）和最薄单点角膜厚度（TP）的重复性。
方法
在这项重复性比较研究中，分析了 36 名正常个体的 36 只眼和 72 名 KC 患者（28 只眼 Z-Kmax3 为≤50.0D，44 只眼 Z-Kmax3 为>50.0D）的 72 只眼的数据。对每只入组眼，进行 6 次成像（每半小时连续采集 3 次）。对于每个参数，从 6 次检查的数据中计算出受试者内标准差（Sw）。
结果
在正常组中，Cspot-Axi-Sw 与 Kmax-Sw 不同（p=0.0004）。此外，Z-Kmax3-Sw 与 Kmax-Sw 不同（p=0.0297）。Cspot-Axi-Sw 与 Z-Kmax3-Sw 之间的差异具有统计学意义（p=0.0482）。在 KC 组中，Cspot-Axi 与 Kmax 之间（p<0.0001）和 Z-Kmax3 与 Kmax 之间（p<0.0001）的 Sw 差异具有统计学意义。在 Z-Kmax3≤50.0D 亚组中，Cspot-Axi 与 Kmax 之间的 Sw 差异具有统计学意义（p=0.0002）。在 Z-Kmax3>50.0D 亚组中，Cspot-Axi 与 Kmax 之间的 Sw 差异具有统计学意义（p<0.0001），Z-Kmax3 与 Kmax 之间的 Sw 差异具有统计学意义（p<0.0001）。在任何研究组中，Spot-Pach 与 TP 之间的 Sw 差异均无统计学意义（均 P>0.05）。
结论
在 KC 的诊断和随访中，Cspot-Axi 和 Z-Kmax3 的区带平均值比单点 Kmax 更可靠。Spot-Pach 的重复性与 TP 相似，这两个变量的用途应该是等效的。
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