AS-OCT测量眼前节虹膜参数可重复性研究

Reproducibility of iris parameters measurements with anterior segment optical coherence tomography

目的 评估使用眼前节光学相干断层成像术（AS-OCT）定量测量虹膜参数的可重复性.方法 横断面研究.对2013年1月至2015年1月在汕头国际眼科中心共纳入受试者105名,平均年龄48.5岁（24～67岁）.分为房角开放（50名受试者）和房角关闭（55名受试者）两组.采用AS-OCT的眼前节单线扫描模式,使用自编程图像处理软件定量测量AS-OCT影像的虹膜参数,包括虹膜厚度,虹膜体积和虹膜曲度.先由一名检查者在不同时间对受试者进行2次检查.再由第二位独立检查者对受试者进行第三次检查.测量不分先后顺序,测量结果双盲.运用组内相关系数（ICC）,变异系数（COV）来评估测量者间和测量者内的可重复性.结果 房角开放眼的虹膜厚度,虹膜面积和虹膜曲度的平均值±标准差分别为（0.40±0.05） mm,（1.67±0.24） mm2和（0.18±0.12） mm;房角关闭眼的虹膜参数分别为（0.42±0.04） mm,（1.62±0.25） mrn2和（0.25±0.11）mm.在房角开放眼组,测量者内和测量者间得出的虹膜厚度,虹膜面积,虹膜曲度的ICC值为0.865～0.982.在房角关闭眼组的ICC值为0.875～0.948.结论 使用AS-OCT定量测量房角开放和房角关闭眼的虹膜参数均可获得高度可重复性。

Objective To determine the repeatability and reproducibility of anterior segment optical coherence tomography （AS-OCT） on the measurement of iris parameters.Methods In this cross-sectional study,105 consecutive subjects,mean age was 48.5 years （range：24-67）,（50 normal open angle subjects and 55 angle-closure subjects） were recruited.One eye from each subject was randomly selected for imaging by AS-OCT using anterior segment single protocol.For intraobserver and interobserver reproducibility,a single observer acquired two sets of images followed by a third set of images acquired by a second observer.AS-OCT images were measured using custom software to determine iris parameters,including iris thickness,iris area and iris curvature.The intraclass correlation coefficient （ICC）,limits of agreement （LOA;mean of differences± 1.96SD of differences）,and coefficient of variation （CV） were calculated as items of intraobserver and interobserver reproducibility.Results The mean and standard deviation of iris thickness,iris area and iris curvature,in open angle group,were 0.40±0.05mm,1.67±0.24 mm2 and 0.18±0.12 mm,respectively;and in angle-closure group,were 0.42±0.04 mm,1.62±0.25 mm2 and 0.25±0.11 mm,respectively.In open angle group,ICC of intraobserver and interobserver measurement was from 0.865 to 0.982.In angle-closure group,the range of ICC was from 0.875 to 0.948.Conclusions The reproducibility of iris parameters measurements with the AS-OCT is good in both open angle and angle closure eyes.