Berger Tim, Flockerzi Elias, Daas Loay, Maiassi Nadir, Seitz Berthold
Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany.
Cornea. 2024 Jul 30;44(6):732-739. doi: 10.1097/ICO.0000000000003645.
Assessment of tomographic characteristics and interdevice comparability between Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) and swept-source optical coherence tomography (CASIA2, Tomey Corp., Nagoya, Japan) in eyes with macular corneal dystrophy (MCD).
Eyes with MCD were examined by Pentacam HR and CASIA2. Interdevice comparison was performed using a Wilcoxon matched pairs test and Bland-Altman plots with 95% limit of agreement. A Spearman rank correlation coefficient was used for correlating indices of both devices.
This retrospective study included 31 eyes of 18 patients (mean age: 32.1 ± 10.7 years). Eyes with MCD demonstrated a moderate astigmatism with a Cylinder anterior of 2.56 ± 1.50 D (Pentacam HR) and 2.52 ± 1.57 D (CASIA2) without a difference between both devices. CASIA2 (0.34 ± 0.14 D) measured lower values of Cylinder posterior compared with Pentacam HR (0.96 ± 0.66 D) ( P < 0.0001). Comparison of pachymetry (Pentacam HR vs. CASIA2) showed higher values of the central corneal thickness (619 ± 227 μm vs. 445 ± 67 μm, P = 0.0001) and the thinnest corneal thickness (499 ± 165 μm vs. 430 ± 60 μm, P = 0.0167) for Pentacam HR. Corneal densitometry measurement revealed that increasing gray scale units caused a greater interdevice difference for pachymetry values, as Pentacam HR measured higher than CASIA2 for more opaque corneas.
Eyes with MCD tend to have thinner corneas and a higher amount of corneal astigmatism than healthy eyes. In advanced MCD, Scheimpflug technology may mistakenly overestimate corneal thickness. The pachymetry measurement of the optical coherence tomography should be used when planning corneal surgery such as excimer laser-assisted phototherapeutic keratectomy to determine the ablation depth.
评估黄斑角膜营养不良（MCD）患者眼中，眼前节分析系统（Pentacam HR，德国韦茨拉尔Oculus Optikgeräte GmbH公司）与扫频光学相干断层扫描（CASIA2，日本名古屋Tomey公司）的断层扫描特征及设备间的可比性。
使用Pentacam HR和CASIA2对患有MCD的眼睛进行检查。采用Wilcoxon配对检验和一致性界限为95%的Bland-Altman图进行设备间比较。使用Spearman等级相关系数对两种设备的指标进行相关性分析。
这项回顾性研究纳入了18例患者的31只眼睛（平均年龄：32.1±10.7岁）。患有MCD的眼睛表现为中度散光，Pentacam HR测量的角膜前表面散光为2.56±1.50 D，CASIA2测量的为2.52±1.57 D，两种设备之间无差异。与Pentacam HR（0.96±0.66 D）相比，CASIA2测量的角膜后表面散光值较低（0.34±0.14 D）（P<0.0001）。眼前节分析系统（Pentacam HR与CASIA2）测量的角膜厚度比较显示，Pentacam HR测量的中央角膜厚度（619±227μm vs. 445±67μm，P = 0.0001）和最薄角膜厚度（499±165μm vs. 430±60μm，P = 0.0167）更高。角膜密度测量显示，随着灰度单位增加，角膜厚度测量值的设备间差异更大，因为对于更混浊的角膜，Pentacam HR测量值高于CASIA2。
与健康眼睛相比，患有MCD的眼睛角膜往往更薄，角膜散光程度更高。在晚期MCD中，眼前节分析技术可能会错误地高估角膜厚度。在规划诸如准分子激光原位角膜磨镶术等角膜手术以确定消融深度时，应使用光学相干断层扫描测量的角膜厚度。
