检影验光在圆锥角膜筛查与诊断中的应用研究

Application study of skiascopie in screening and diagnosis of suspected keratoconus

[目的]探讨分析利用检影验光在筛查与诊断圆锥角膜中的准确性。[方法]收集2008年11月—2011年11月期间利用检影验光观察瞳孔区影动形态异常方法诊断为疑似圆锥角膜病例32例53只眼,经角膜地形图仪检查明确诊断是否相符,并对诊断不符合病例进行分析。[结果]检影验光筛查诊断为疑似圆锥角膜32例53只眼中,经角膜地形图仪确诊圆锥角膜27例43只眼,不符合5例10只眼,不符合的主要原因为高度近视与散光,高度不规则散光引起的异常检影影动干扰所致。检影验光未诊断为疑似圆锥角膜的11只眼中,经角膜地形图仪确诊圆锥角膜4只眼,不符合的主要原因为圆锥角膜病变程度轻,病变位于周边角膜及散光度数较低,检影异常影动不明显。[结论]在角膜地形图检查对高度近视散光人群普查难以实现时,检影验光中影动形态异常反映了圆锥角膜的主要特征,对筛查圆锥角膜有较高的诊断价值。

[ Objective] To evaluate the diagnostic accuracy of skiascopie for suspected keratoconus. [ Methods] Abnor- mal photokinesis of pupil area of the patients with suspected keratoconus were obtained by skiascopie, compared with the results of corneal topography and selected during November 2008 to November 2011. Any discrepancies of the results of the two methods were then analyzed. [ Results] The results of 53 eyes of 32 patients with suspected keratoconas were diag- nosed by skiascopie, and were accordant in 27 patients （43 eyes） by corneal topography and inconsistent in 5 patients （10 eyes） due to the interference of abnormal photokinesis which caused by the high myopia and myopic astigmatism, irregular astigmatism. In the 11 eyes with not suspected keratoconus were diagnosed by skiascopie, 4 eyes were accordant by corneal topography. The main reason due to the interference of mild pattern and located in the peripheral cornea, low astigmatism, so abnormal photokinesis is not obvious. [Conclusion] The abnormal photokinesis of skiascopie reflects the main features of the keratoconus, therefore it can be a valuable screening and diagnosis method for keratoconus, especially in the situation that corneal topography difficult to achieve the screening of high myopia and astigmatism population.