Pentacam眼前节分析仪诊断早期圆锥角膜的临床应用

Clinical application of Pentacam anterior segment analyzer in the diagnosis of early keratoconus

目的:探讨Pentacam眼前节分析仪在早期圆锥角膜诊断中的临床应用。方法:选取2019-02/12于我院就诊的早期圆锥角膜患者49例49眼纳入研究,参照Rabinowitz诊断标准,将其分为临床期圆锥角膜组27例27眼和亚临床期圆锥角膜组22例22眼,另选取20例20眼有近视、散光史的正常眼作为对照组。采用Pentacam眼前节分析仪分别测定3组受检者角膜表面变异指数(ISV)、圆锥角膜指数(KI)、垂直不对称指数(IVA)、中央圆锥角膜指数(CKI)、高度离心指数(IHD)、高度不对称性指数(IHA)、不规则指数(ABR)、最小曲率半径(Rmin)、角膜散光(CYL)、角膜前表面高度(AE)、角膜前表面最大屈光力(Kmax)、角膜后表面高度(PE)变化,比较三组受检者各指标检测值,绘制ROC曲线,分析各指标诊断圆锥角膜的临床价值。结果:三组受检者ISV、KI、IVA、CKI、IHD、IHA、ABR、Rmin、CYL、AE、Kmax、PE检测值比较有差异(P<0.05);临床期圆锥角膜组受检者ISV、KI、IVA、CKI、IHD、IHA、ABR、Rmin、CYL、AE、Kmax、PE检测值与对照组比较有差异(P<0.05);亚临床期圆锥角膜组受检者ISV、KI、IVA、CKI、IHD、IHA、ABR、Rmin、CYL、AE、Kmax、PE检测值与对照组比较有差异(P<0.05);ROC曲线分析结果显示,IVA、KI、AE、PE、Rmin、IHD、Kmax、ISV、ABR诊断临床期圆锥角膜的敏感度和特异度均较高;IVA、Rmin、AE、PE诊断亚临床期圆锥角膜的敏感度和特异度均较高。结论:Pentacam眼前节分析仪可精确测量角膜前后表面形态学参数,其在圆锥角膜早期临床诊断中发挥重要作用。

AIM:To explore the clinical application of Pentacam anterior segment analyzer in early keratoconus diagnosis.METHODS:Selected 49 patients(49 eyes)with early keratoconus who were treated in our hospital from February 2019 to December 2019.According to the Rabinowitz diagnostic criteria,they were divided into 27 cases(27 eyes)in the clinical keratoconus group and 22 cases(22 eyes)in the subclinical keratoconus group.Another 20 cases(20 eyes)of normal eyes with myopia and astigmatism were selected as the control group.The Pentacam anterior segment analyzer was used to determine the index of surface variance(ISV),keratoconus index(KI),index of vertical asymmetry(IVA),central keratoconus index(CKI),index of highest decentration(IHD),index of highest asymmetry(IHA),aberration coefficient,minimum sagittal curvature(Rmin),corneal astigmatism(CYL),corneal anterior surface height(AE),maximum refractive power of the cornea and corneal posterior surface height(PE).Compare the detection values of the three groups of indicators,and draw the ROC curve,and analyze the clinical value of various indicators in diagnosing keratoconus.RESULTS:The three groups of ISV,KI,IVA,CKI,IHD,IHA,ABR,Rmin,CYL,AE,Kmax and PE detection values were significantly different(P<0.05).Compared with the control group,the ISV,KI,IVA,CKI,IHD,IHA,ABR,Rmin,CYL,AE,Kmax and PE detection value in the clinical keratoconus group were statistically significant(P<0.05).Compared with the control group,the ISV,KI,IVA,CKI,IHD,IHA,ABR,Rmin,CYL,AE,Kmax and PE detection value in the clinical keratoconus group were statistic significant(P<0.05).The results of ROC curve analysis showed that the sensitivity and specificity of keratoconus in the clinical phase of IVA,KI,AE,PE,Rmin,IHD,Kmax,ISV and ABR were higher.IVA,Rmin,AE and PE diagnosis of subclinical keratoconus sensitivity and specificity were higher.CONCLUSION:The Pentacam anterior segment analyzer accurately measures the morphological parameters of the anterior and posterior surface of the cornea,which plays an important role in the early clinical diagnosis of keratoconus.