Yuhas Phillip T, Fortman Maddison M, Nye Michael, Mahmoud Ashraf M, Roberts Cynthia J
College of Optometry, The Ohio State University, Columbus, OH, USA.
Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.
Curr Eye Res. 2025 Jul;50(7):700-709. doi: 10.1080/02713683.2025.2489607. Epub 2025 Apr 10.
To test whether the intraocular-pressure (IOP) and biomechanical outcome metrics from the Ocular Response Analyzer (ORA) differ between the measurement with the highest waveform score and the average of four measurements of any waveform score in participants with keratoconus and in controls.
Patients with diagnosed keratoconus and healthy controls were recruited prospectively. Four measurements were made using a third-generation ORA. Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc), corneal hysteresis (CH), corneal resistance factor (CRF), waveform score, and six waveform parameters (p1area, p2area, w1, w2, h1, and h2) were considered as outcome metrics. In the left eye, outcomes from the measurement with the highest waveform score were compared against averaged outcomes from four measurements of any waveform score using either paired t-tests or Wilcoxon signed-rank tests. Receiver operating characteristic (ROC) curves tested ability of both data-selection approaches to differentiate the cohorts.
One-hundred ninety-two ( = 192) participants were enrolled. In the control cohort ( = 145), waveform score, CH, p2area, and h2 were all significantly greater for the best-waveform-score measurement than for the average-waveform-score measurement. IOPcc and w2 were significantly less for the best-waveform-score measurement than for the average-waveform-score measurement. In the keratoconus cohort ( = 47), waveform score, p1area, p2area, h1, and h2 were all significantly greater for the best-waveform-score measurement than for the average-waveform-score measurement. W2 was significantly less for the best-waveform-score measurement than for the average-waveform-score measurement. The area under the ROC curve was high for both data-selection approaches.
In general, the best measurement had higher and narrower waveform peaks than the averaged measurement, which suggests better alignment between the device and the eye in the former than in the latter. Thus, making multiple measurements and then analyzing the one with the single highest quality may be preferred to analyzing the average of the group.
测试圆锥角膜患者和对照组中，眼反应分析仪（ORA）测量的眼内压（IOP）和生物力学结果指标在波形分数最高的测量值与任何波形分数的四次测量平均值之间是否存在差异。
前瞻性招募已确诊的圆锥角膜患者和健康对照者。使用第三代ORA进行四次测量。将Goldmann相关眼压（IOPg）、角膜补偿眼压（IOPcc）、角膜滞后（CH）、角膜阻力因子（CRF）、波形分数和六个波形参数（p1面积、p2面积、w1、w2、h1和h2）视为结果指标。在左眼，使用配对t检验或Wilcoxon符号秩检验，将波形分数最高的测量结果与任何波形分数的四次测量平均值进行比较。受试者工作特征（ROC）曲线测试了两种数据选择方法区分两组人群的能力。
共纳入192名参与者。在对照组（n = 145）中，波形分数最高的测量值的波形分数、CH、p2面积和h2均显著高于波形分数平均值的测量值。波形分数最高的测量值的IOPcc和w2显著低于波形分数平均值的测量值。在圆锥角膜组（n = 47）中，波形分数最高的测量值的波形分数、p1面积、p2面积、h1和h2均显著高于波形分数平均值的测量值。波形分数最高的测量值的w2显著低于波形分数平均值的测量值。两种数据选择方法的ROC曲线下面积均较高。
一般来说，最佳测量的波形峰值比平均测量的更高、更窄，这表明在前一种情况下设备与眼睛的对准比后一种情况更好。因此，进行多次测量然后分析质量最高的单次测量结果可能比分析组平均值更可取。
