中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2015年
2期
135-140
,共6页
生物测量%角膜厚度%近视%Optovue iVue OCT%Pentacam%Visante OCT
生物測量%角膜厚度%近視%Optovue iVue OCT%Pentacam%Visante OCT
생물측량%각막후도%근시%Optovue iVue OCT%Pentacam%Visante OCT
Bio-measurement%Cornea thickness%Myopia%Optovue iVue OCT%Pentacam%Visante OCT
背景 角膜厚度测量对角膜屈光手术和眼病的诊断具有重要意义,Optovue iVue OCT是测量角膜厚度的新型频域OCT,了解其测量角膜厚度的可重复性及其与目前常用的Pentacam、Visante OCT的一致性,有助于对其临床应用价值进行客观评价. 目的 评价Optovue iVue OCT测量角膜厚度的可重复性,分析其与Pentacam三维眼前节分析诊断系统、Visante OCT测量角膜厚度的一致性. 方法 选取45例拟行角膜屈光手术的近视患者的右眼,分别用Optovue iVue OCT、Pentacam、Visante OCT对角膜最薄点、中央点和距角膜中央1 mm的3:00、6:00、9:00、12:00位进行厚度测量,采用组内相关系数(ICC)对Optovue iVue OCT 3次测量的可重复性进行分析,采用Bland-Altman一致性检验分析Optovue iVue OCT与Pentacam、Visante OCT的一致性;对Optovue iVue OCT所测8个象限的平均角膜厚度进行分析. 结果 Optovue iVue OCT在6个点的3次角膜厚度测量结果差异无统计学意义(P=0.546),角膜最薄点、中央点、距角膜中央半径1 mm的3:00、6:00、9:00、12:00位ICC分别为99.92％、99.99％、99.96％、99.99％、99.99％和99.97％;Optovue iVue OCT、Visante OCT、Pentacam在6个点所测的角膜厚度值组间比较差异均有统计学意义(P=0.000、0.001、0.000、0.003、0.002、0.000).两两比较结果显示,Optovue iVue OCT所测6个点角膜厚度值比Pentacarm测量值平均低24.20 μm,差异均有统计学意义(P=0.000、0.001、0.000、0.003、0.004、0.000),一致性检验差异较大.Optovue iVue OCT测量的角膜厚度与Visante OCT比较,除12:00位差异有统计学意义(P=0.016)外,其余各点差异均无统计学意义(P=1.000、0.447、0.239、1.000、1.000),一致性较好.Pentacam所测角膜厚度值比Visante OCT测量值平均高14.01 μm,除中央点差异无统计学意义(P=0.056)外,其余各点差异均有统计学意义(P=0.009、0.005、0.034、0.017、0.008),一致性较差.Optovue iVue OCT所测8个象限平均角膜厚度颞下象限最薄者23例,占51.11％,上方和鼻上象限最厚者各21例,分别占46.66％. 结论 Optovue iVue OCT测量角膜厚度重复性好,其测量值与Visante OCT一致性好,但与Pentacam测量角膜厚度一致性差异较大,互相替代使用时应慎重.Optovue iVue OCT所测各象限平均角膜厚度大多数颞下象限最薄,鼻上、上方象限较厚.
揹景 角膜厚度測量對角膜屈光手術和眼病的診斷具有重要意義,Optovue iVue OCT是測量角膜厚度的新型頻域OCT,瞭解其測量角膜厚度的可重複性及其與目前常用的Pentacam、Visante OCT的一緻性,有助于對其臨床應用價值進行客觀評價. 目的 評價Optovue iVue OCT測量角膜厚度的可重複性,分析其與Pentacam三維眼前節分析診斷繫統、Visante OCT測量角膜厚度的一緻性. 方法 選取45例擬行角膜屈光手術的近視患者的右眼,分彆用Optovue iVue OCT、Pentacam、Visante OCT對角膜最薄點、中央點和距角膜中央1 mm的3:00、6:00、9:00、12:00位進行厚度測量,採用組內相關繫數(ICC)對Optovue iVue OCT 3次測量的可重複性進行分析,採用Bland-Altman一緻性檢驗分析Optovue iVue OCT與Pentacam、Visante OCT的一緻性;對Optovue iVue OCT所測8箇象限的平均角膜厚度進行分析. 結果 Optovue iVue OCT在6箇點的3次角膜厚度測量結果差異無統計學意義(P=0.546),角膜最薄點、中央點、距角膜中央半徑1 mm的3:00、6:00、9:00、12:00位ICC分彆為99.92％、99.99％、99.96％、99.99％、99.99％和99.97％;Optovue iVue OCT、Visante OCT、Pentacam在6箇點所測的角膜厚度值組間比較差異均有統計學意義(P=0.000、0.001、0.000、0.003、0.002、0.000).兩兩比較結果顯示,Optovue iVue OCT所測6箇點角膜厚度值比Pentacarm測量值平均低24.20 μm,差異均有統計學意義(P=0.000、0.001、0.000、0.003、0.004、0.000),一緻性檢驗差異較大.Optovue iVue OCT測量的角膜厚度與Visante OCT比較,除12:00位差異有統計學意義(P=0.016)外,其餘各點差異均無統計學意義(P=1.000、0.447、0.239、1.000、1.000),一緻性較好.Pentacam所測角膜厚度值比Visante OCT測量值平均高14.01 μm,除中央點差異無統計學意義(P=0.056)外,其餘各點差異均有統計學意義(P=0.009、0.005、0.034、0.017、0.008),一緻性較差.Optovue iVue OCT所測8箇象限平均角膜厚度顳下象限最薄者23例,佔51.11％,上方和鼻上象限最厚者各21例,分彆佔46.66％. 結論 Optovue iVue OCT測量角膜厚度重複性好,其測量值與Visante OCT一緻性好,但與Pentacam測量角膜厚度一緻性差異較大,互相替代使用時應慎重.Optovue iVue OCT所測各象限平均角膜厚度大多數顳下象限最薄,鼻上、上方象限較厚.
배경 각막후도측량대각막굴광수술화안병적진단구유중요의의,Optovue iVue OCT시측량각막후도적신형빈역OCT,료해기측량각막후도적가중복성급기여목전상용적Pentacam、Visante OCT적일치성,유조우대기림상응용개치진행객관평개. 목적 평개Optovue iVue OCT측량각막후도적가중복성,분석기여Pentacam삼유안전절분석진단계통、Visante OCT측량각막후도적일치성. 방법 선취45례의행각막굴광수술적근시환자적우안,분별용Optovue iVue OCT、Pentacam、Visante OCT대각막최박점、중앙점화거각막중앙1 mm적3:00、6:00、9:00、12:00위진행후도측량,채용조내상관계수(ICC)대Optovue iVue OCT 3차측량적가중복성진행분석,채용Bland-Altman일치성검험분석Optovue iVue OCT여Pentacam、Visante OCT적일치성;대Optovue iVue OCT소측8개상한적평균각막후도진행분석. 결과 Optovue iVue OCT재6개점적3차각막후도측량결과차이무통계학의의(P=0.546),각막최박점、중앙점、거각막중앙반경1 mm적3:00、6:00、9:00、12:00위ICC분별위99.92％、99.99％、99.96％、99.99％、99.99％화99.97％;Optovue iVue OCT、Visante OCT、Pentacam재6개점소측적각막후도치조간비교차이균유통계학의의(P=0.000、0.001、0.000、0.003、0.002、0.000).량량비교결과현시,Optovue iVue OCT소측6개점각막후도치비Pentacarm측량치평균저24.20 μm,차이균유통계학의의(P=0.000、0.001、0.000、0.003、0.004、0.000),일치성검험차이교대.Optovue iVue OCT측량적각막후도여Visante OCT비교,제12:00위차이유통계학의의(P=0.016)외,기여각점차이균무통계학의의(P=1.000、0.447、0.239、1.000、1.000),일치성교호.Pentacam소측각막후도치비Visante OCT측량치평균고14.01 μm,제중앙점차이무통계학의의(P=0.056)외,기여각점차이균유통계학의의(P=0.009、0.005、0.034、0.017、0.008),일치성교차.Optovue iVue OCT소측8개상한평균각막후도섭하상한최박자23례,점51.11％,상방화비상상한최후자각21례,분별점46.66％. 결론 Optovue iVue OCT측량각막후도중복성호,기측량치여Visante OCT일치성호,단여Pentacam측량각막후도일치성차이교대,호상체대사용시응신중.Optovue iVue OCT소측각상한평균각막후도대다수섭하상한최박,비상、상방상한교후.
Background Measurement of corneal thickness is of great significance for the design of refractive surgery and the diagnosis of eye diseases,measuring equipments and technology develop rapidly in recent years.Optovue iVue OCT is a new frequency-domain optical coherence tomography (OCT),to compare its results with those of Pentacam and Visante OCT is helpful to objectively assess the clinical value of Optovue iVue OCT.Objective This study was to investigate the repeatability of corneal thickness measurement with Optovue iVue OCT and the comparatbility with Pentacam three-dimensional anterior segment analysis diagnostic system and Visante OCT.In addition,this study attempted to analyze the distribution of average corneal thickness in each quadrant by Optovue iVue OCT.Methods The corneal thicknesses of the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones 1 mm away from the center of the cornea were measured in 45 right eyes of 45 subjects with myopia using Optovue iVue OCT,Pentacam and Visante OCT in Tianjin Eye Hospital.Interclass correlation coefficient (ICC) was used to analyze the repeatability of measurement by Optovue iVue OCT.The agreements between Optovue iVue OCT and Pentacam or Visante OCT were evaluated by Bland-Altman test.The corneal area of 1.0-2.5 mm away from the center was divided into eight quadrants and the average corneal thickness of each quadrant was measured and analysis with Optovue iVue OCT.Results No significant difference was found in corneal thickness values for 3 times by Optovue iVue OCT (P=0.546).The ICC by Optovue iVue OCT was 99.92％,99.99％,99.96％,99.99％,99.99％ and 99.97％ at the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones respectively.There were significant differences among the 3 kinds of methods (P =0.000,0.001,0.000,0.003,0.002,0.000).The measured values of Optovue iVue OCT were significantly lower mean 24.20 μm than those of Pentacam (P=0.000,0.001,0.000,0.003,0.004,0.000),but only the value at 12:00 zone of Optovue iVue OCT was evidently declined in comparison with that of Visante OCT (P =0.016),there were no significant differences between all the other zones (P =1.000,0.447,0.239,1.000,1.000).While the mean corneal thickness value from Pentacam lowed by 14.01 μm in comparison with Visante OCT,all zones had significant differences (P =0.009,0.005,0.034,0.017,0.008) except the central point (P =0.056).Based on the Optovue iVue OCT,the thinnest zone was at temporal quadrant in 23 eyes (accounting for 51.11％) and at superior quadrant or super nasal quadrant in 21 eyes (both at 46.66％).Conclusions Optovue iVue OCT measurement of corneal thickness is of high repeatability and is consistent with Visante OCT in myopic eye.Optovue iVue OCT shows evident difference from Pentacam in the measurement of corneal thickness.The thinnest point of the cornea is mainly in the inferior temporal quadrant and the thickest point is commonly in superior quadrant and nasal superior quadrant based on Optovue iVue OCT.
