Department of Ophthalmology, Faculty of Medicine, Harran University, Şanlıurfa, Türkiye.
Department of Ophthalmology, Private Dünyagöz Hospital, Istanbul, Türkiye.
Int Ophthalmol. 2024 Oct 3;44(1):400. doi: 10.1007/s10792-024-03318-z.
This study aimed to compare and correlate specular microscope indices and corneal topography indices in different stages of keratoconus.
Two hundred forty-six eyes of 123 participants were enrolled in the study. Corneal topography was performed using Sirius (CSO, Italy), with a rotating Scheimpflug camera and a Placido disc topographer. Corneal endothelial cell indices were assessed using a specular microscope (Nidek CEM-530, Japan). Eyes were graded as keratoconus stages 0-4 according to the Amsler-Krumeich classification. Corneal topography and endothelial cell indices were compared among the groups, and the correlations between them were analyzed.
The mean age of the patients was 23.26 ± 6.75 years (range, 14-47 years). Forty-eight cases were male (39%) and 75 were female (61%). There were no statistically significant age (p = 0.578) or sex ratio (p = 0.529) differences between the groups. Twenty-nine eyes were included in the control group (11.78%), while 41 (16.67%) had stage 1 keratoconus, 88 (35.77%) had stage 2, and 88 (35.77%) had stage 3. Measurement was not possible in stage 4 keratoconus. No statistically significant difference was determined in specular microscopy values according to the stage of keratoconus, except for the number of analyzed cells (NUM) (p > 0.05). The lowest NUM values were observed in stages 1, 2, and 3, with values of 184.34 ± 67.62 cells/mm, 155.07 ± 59.48 cells/mm, and 127.06 ± 64.39 cells/mm, respectively (p = 0.001). In the keratoconus group, weak statistically significant negative correlations were observed between NUM and SimK1, SimK2, KVf, BCVf, KVb, and BCVb, while a weak positive correlation was noted between NUM and central corneal thickness (p < 0.05).
NUM seems to decrease, while endothelial cell density exhibits no significant changes, with the progression of keratoconus. It appears that as keratoconus index values increase, NUM may decrease in different stages of keratoconus.
本研究旨在比较和分析不同阶段圆锥角膜的角膜内皮显微镜指数和角膜地形图指数。
本研究纳入了 123 名参与者的 246 只眼。使用 Sirius（CSO，意大利）角膜地形图仪进行角膜地形图检查，该仪器采用旋转 Scheimpflug 相机和 Placido 盘式角膜地形图仪。使用 Nidek CEM-530 角膜内皮显微镜（日本）评估角膜内皮细胞指数。根据 Amsler-Krumeich 分类，将眼分为 0-4 级。比较各组之间的角膜地形图和内皮细胞指数，并分析它们之间的相关性。
患者的平均年龄为 23.26±6.75 岁（范围 14-47 岁）。48 例为男性（39%），75 例为女性（61%）。组间年龄（p=0.578）或性别比例（p=0.529）差异无统计学意义。29 只眼纳入对照组（11.78%），41 只眼（16.67%）为 1 级圆锥角膜，88 只眼（35.77%）为 2 级，88 只眼（35.77%）为 3 级。4 级圆锥角膜无法进行测量。除分析细胞数（NUM）外（p>0.05），角膜内皮显微镜值在圆锥角膜阶段无统计学差异。NUM 值最低的是 1 级、2 级和 3 级，分别为 184.34±67.62 个/mm、155.07±59.48 个/mm 和 127.06±64.39 个/mm（p=0.001）。在圆锥角膜组中，NUM 与 SimK1、SimK2、KVf、BCVf、KVb 和 BCVb 呈弱的统计学负相关，与中央角膜厚度呈弱的统计学正相关（p<0.05）。
随着圆锥角膜的进展，NUM 似乎减少，而内皮细胞密度没有明显变化。似乎随着圆锥角膜指数值的增加，NUM 在圆锥角膜的不同阶段可能会减少。
