基于超广角光学相干断层扫描的眼底曲率作为后巩膜葡萄肿的临床标志物

Fundus Curvature as a Clinical Marker for Posterior Staphyloma Based on Widefield Optical Coherence Tomography.

作者信息

Luo Nan, Liu Bingqian, Wang Lu, Yang Zhi, Wang Peiyuan, Ho Mary, Mak Andrew Chun Yue, Liu Yunyi, Song Yunhe, Zheng Yingfeng, Du Shaolin, Ding Xiaoyan, Lu Lin, Huang Jingjing, Wang Wei, Huo Li, Ohno-Matsui Kyoko, Chen Shida

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (N.L., B.L., P.W., Y.L., Y.S., Y.Z., X.D., L.L., J.H., W.W., S.C.), Guangzhou, China.

The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (L.W.), Guangzhou, China.

出版信息

Am J Ophthalmol. 2025 Mar;271:478-487. doi: 10.1016/j.ajo.2024.12.020. Epub 2024 Dec 27.

DOI:10.1016/j.ajo.2024.12.020

PMID:39733785

Abstract

PURPOSE

To investigate the ability to quantify fundus curvature and detect posterior staphyloma using widefield optical coherence tomography (OCT).

DESIGN

Cross-sectional diagnostic evaluation.

METHODS

This study reviewed 205 highly myopic eyes of 205 participants. The Gaussian curvature map of the fundus was automatically calculated from 2 million scan points over an area of 24 mm × 20 mm, visualizing localized deformations in the posterior region. Two fovea-centered areas were designated as follows: a 6 mm × 6 mm macular region and an 8 mm × 16 mm posterior region. Macular mean curvature, macular curvature deviation, posterior mean curvature, posterior curvature deviation (PCD), and maximum posterior curvature were calculated. The relationship between curvature indices, ocular parameters, and myopic complications was investigated. The diagnostic ability of curvature indices for posterior staphyloma was evaluated.

RESULTS

The mean (SD) age of 205 participants was 34.06 (12.74) years, with 107 being female (52.2%). Posterior staphyloma was found in 33 of 205 (16.1%) eyes. The curvature value map and curvature deviation map revealed detailed morphologic patterns of posterior staphyloma. Eyes with staphyloma had a steeper and more irregular fundus than eyes without staphyloma, with a larger maximum posterior curvature (20.420 × 10 mm vs 10.925 × 10 mm, P < .001), posterior mean curvature (6.754 × 10 mm vs 5.352 × 10 mm, P = .002), macular curvature deviation (1.889 × 10 mm vs 1.078 × 10 mm, P < .001), and PCD (3.894 × 10 mm vs 1.683 × 10 mm, P < .001). However, no difference in macular mean curvature was found between eyes with and without posterior staphyloma. Larger maximum posterior curvature, macular curvature deviation, and PCD were associated with greater degrees of myopia, more severe myopic maculopathy, and worse best-corrected visual acuity (all P < .05). PCD demonstrated the ability to discriminate the presence of posterior staphyloma (area under the curve 0.909 [95% CI 0.854-0.963; P < .001]). The optimal cutoff value of PCD was 3.060 × 10 mm (Youden index = 0.725), with a specificity of 90.7% and a sensitivity of 81.8%.

CONCLUSION

Widefield OCT-based analysis of fundus curvature enhances detection and quantitative assessment of posterior staphyloma in high myopia.

摘要

目的

探讨使用广角光学相干断层扫描（OCT）量化眼底曲率和检测后巩膜葡萄肿的能力。

设计

横断面诊断评估。

方法

本研究回顾了205名参与者的205只高度近视眼。眼底的高斯曲率图由24 mm×20 mm区域内的200万个扫描点自动计算得出，可显示后部区域的局部变形。以黄斑中心为中心的两个区域定义如下：一个6 mm×6 mm的黄斑区域和一个8 mm×16 mm的后部区域。计算黄斑平均曲率、黄斑曲率偏差、后部平均曲率、后部曲率偏差（PCD）和最大后部曲率。研究曲率指数、眼部参数和近视并发症之间的关系。评估曲率指数对后巩膜葡萄肿的诊断能力。

结果

205名参与者的平均（标准差）年龄为34.06（12.74）岁，其中107名女性（52.2%）。205只眼中有33只（16.1%）发现后巩膜葡萄肿。曲率值图和曲率偏差图显示了后巩膜葡萄肿的详细形态模式。有葡萄肿的眼睛比没有葡萄肿的眼睛眼底更陡峭、更不规则，最大后部曲率更大（20.420×10⁻³mm对10.925×10⁻³mm，P <.001），后部平均曲率更大（6.754×10⁻³mm对5.352×10⁻³mm，P =.002），黄斑曲率偏差更大（1.889×10⁻³mm对1.078×10⁻³mm，P <.001），PCD更大（3.894×10⁻³mm对1.683×10⁻³mm，P <.001）。然而，有和没有后巩膜葡萄肿的眼睛之间黄斑平均曲率没有差异。更大的最大后部曲率、黄斑曲率偏差和PCD与更高程度的近视、更严重的近视性黄斑病变和更差的最佳矫正视力相关（所有P <.05）。PCD显示出区分后巩膜葡萄肿存在的能力（曲线下面积0.909 [95% CI 0.854 - 0.963；P <.001]）。PCD的最佳截断值为3.060×10⁻³mm（约登指数 = 0.725），特异性为90.7%，敏感性为81.8%。