Pentacam及OrbscanⅡ角膜地形图在可疑圆锥角膜的诊断特点分析VIP专享VIP免费

史堡咀型苤查!!!!芏!旦筮塑鲞箜堡塑g!也』QP!!!尘坐!!：垒P堕!!Q!!：!尘：塑：盟!：!Pentacam及Orbscan11角膜地形图在可疑圆锥角膜的诊断特点分析杜显丽陈敏马玲王秀先谢立信【摘要】目的比较Pentacam及OrbscanlI在正常人及各期圆锥角膜的测量值及形态学特点，并进一步分析两者早期筛查可疑圆锥角膜的敏感性及有效性。方法选取正常人196只眼、可疑圆锥角膜50只眼、完成期圆锥角膜73只眼，分别行两种角膜地形图检查。观察角膜前、后表面曲率、最佳拟合球面(BFS)、I-S值(Inferior—Superior)(3及5him)、高度图分类、高度值、角膜厚度等指标变化。采用单因素方差分析及秩和检验对数据进行统计学分析。结果Pentacam和OrbscanII测量正常人角膜后表面的Kmax分别为(一6．5±0．2)、(一6．7±0．8)D，Kmin分别为(一6．04-0．9)、(一6．1±0．5)D，差异有统计学意义(Z=一10．5，一5．1；P<0．05)；其他如角膜前后表面BFS、高度值、厚度值等的测量值Pentaeam也较小。高度图形态Pentaeam正常组、可疑组均以递减为主，其递增型前表面分别为14．4％(28／196)及20．o％(10／50)，后表面为2．0％(4／196)及26．o％(13／50)；完成期组前表面91．7％(67／73)、后表面94．5％(69／73)为递增型。Orbscan正常组80．4％(165／196)递增型，可疑、完成期圆锥角膜组全递增型。ROC曲线敏感指标及cutoff值：Orbscan角膜前、后表面I—s值(3mm及5mm)对可疑圆锥角膜的诊断灵敏，角膜前表面5lnnl的cutoff值为1．15D，后表面为0．65D。Pentacam除I—s值敏感外，角膜前、后表面高度值亦具良好的诊断价值；角膜前表面高度cutoff值4．5Ixm，角膜后表面7．5txm。结论两仪器在正常人多个指标差异有统计学意义，Pentacam数值小。两仪器I—s值对可疑圆锥角膜筛查灵敏，而结合高度图形态及高度值Pentacam诊断价值更高，高度图递增型角膜前突危险增大。f中华腠科杂志，2012，48：323-329)【关键词】圆锥角膜；角膜地形图ComparisonofPentacamandOrbscanlIsystemsforthediagnosisofkeratoconussuspectsDUXian—b，CHENMin．MALing．WANGXiu—xian．XIELi—xin．StateKeyLaboratoryCultivationBase，ShandongProvincialLaboratoryofOphthalmology，ShandongEyeInstitute，Qingdao266071，ChinaCorrespondingauthor：CHENMin，Emaif：minqd@hotmaiLcom【Abstract】0bjectiveTocomparethesensitivityofPentacanlandOrbscanⅡandtoanalyzethemorphologycharacteristicoftopographyinnormaleyesanddifferentstagesofkeratoconus，toprovidethebasisforearlyscreeningofkeratoeonussuspects．MethodsOnehundredandninetysixnormaleyes，50eyeswithkeratoconussuspectand73eyeswithclinicalkeratoconuswereenrolled．Thechangesofcomealanterior／posteriorcurvature，bestfittingsphere(BFS)．Inferior—Superiorvalue(I-S)(3mMand5mm)，classificationofelevationmapsandcornealthicknessweremeasured．ResultsThereweresignificantdifferencesincludingposteriorcurvature．anterior／posteriorBFS，elevationvalueandcomealthicknessinnornlaleyesbetweenthedatameasuredbythesetwodifferentinstruments．valuesobtainedbyPentacamwerelessthanthosebyOrbscan．Concerningtheelevationmapspattern，theprogressivelydecreasingpatternwasdominantinPentacamwithnormaleyesandkeratocomussuspects，withtheprogressivelyincreasingpatternaccountingfor14．4％(28／196)and20．0％(10／50)respectivelyinanteriorsurface，and2．0％(41／96)and26．0％(13／50)inposteriorsurface．Theprogressivelyincreasingpatternwasindominantwithclinicalkeratoconus，accountingfor91．7％(67／73)and94．5％(69／73)respectivelyinanteriorandposteriorsurface．ProgressivelyincreasingpatterninOrbscanwaspresentedin80．4％(165／196)normaleyesandsuspectedorclinicalstagekeratoconus．Astothereceiver—operating—characteristic(ROC)curvesandcutoffvalue．0rbscanI-Svalue(3nlmand5mm)ofanteriorandposteriorsurfacewassensitive...