A超与IOL Master测量黄斑区水肿患者眼轴长度的比较

Axial length measurement in eyes with macular edema A-scan ultrasound versus IOL Master

目的比较A超与光学相干生物测量仪(IOL Master)测量临床上黄斑区明显水肿患者眼球轴长的差异,并寻找此差异与黄斑中心凹厚度的关系。方法将实验对象分为2组:第1组28例患者42只眼,全部为正常健康成年人;第2组25例患者25只眼,全部为视网膜黄斑区有明显水肿的患者。分别应用A超与IOLMaster测量全部实验眼球轴长,使用光学相干断层扫描仪(OCT)测量全部实验眼黄斑中心凹厚度;使用t检验比较两种方法测量眼球轴长结果的差异,使用Pearson相关系数衡量此差异与黄斑中心凹厚度的关系。结果A超和IOL Master测量健康组眼球轴长分别为(23.01±1.21)mm和(23.16±1.01)mm,差别无统计学意义(P=0.24);A超和IOL Master测量黄斑区水肿组眼球轴长分别为(23.16±0.87)mm和(23.29±0.56)mm,差别有统计学意义(P=0.013)。两组实验对象黄斑中心凹厚度分别为(182±23)μm和(432±135)μm。两组内眼球轴长差异与黄斑中心凹厚度的Pearson相关系数分别为0.31和0.78。结论应用A超与IOLMaster测量黄斑区水肿患者眼球轴长的结果差异有统计学意义,此差异与黄斑中心凹厚度有一定相关性,这主要是由于两种测量方法的原理不同。使用OCT测量的黄斑中心凹厚度有助于评估此差异。

Objective To compare axial length （AL） measurements obtained with ultrasound （US） and IOL Master in eyes with clinically significant macular edema and to examine the correlation between measurement difference and foveal thickness. Methods The objects were divided into 2 groups. The first group included 42 healthy eyes （28 persons） and the second group included 25 eyes （25 persons） with macular edema. AL was prospectively measured using US and IOL Master in eyes of both groups. Foveal thickness was evaluated by Pearson coefficient. Results Mean AL by US and IOL Master in healthy eves were （23.01±1.21 ） mm and （23. 16±1.01） ram, respectively （P=0.24）; in macular edema eyes, it were （23. 16±0.87） mm and （23.29±0.56 ） ram, respectively （P = 0. 013）. Mean deviation toveal thickness in healthy and macular edema eves were （182±23 ） μm and （432 ±135） μm respectively. Correlation between AL difference and toveal thickness was poor in healthy （r =0.31 ） but strong in maeular edema （r =0.78）eyes. Conclusion AL measurements using US and IOL Master in eyes with macular edema differ statistically and clinically significantly. This is likely a result of the fundamentally different methodology of the two methods. Foveal thickness measured by OCT is helpful to evaluate the difference between the results of two methods in eyes with significant macular edema.