CAJ | 학술논문

背景调节是指人眼为看清近物改变屈光力的能力,调节过程中眼轴长度(AL)的变化一直是研究难点. 目的本研究中利用超长深度扫描OCT(UL-OCT)对人工晶状体(IOL)眼调节下AL变化的重复性进行评价,为研究眼轴变化与眼调节的关系提供参考. 方法采用前瞻性研究设计.纳入2014年10月至2015年1月在温州医科大学附属眼视光医院行白内障摘出联合单焦点IOL植入术的年龄相关性白内障患者12例20眼,年龄56 ～ 84岁,平均(69.9±7.6)岁,用自主研发的UL-OCT经瞳孔对放松状态或调节状态下的全眼图像进行拍摄.UL-OCT光源中心波长为840 nm,轴向分辨率为7μm,扫描深度为37.71 mm(空气中),采用自主开发设计软件对所得图像进行分析计算,获得中央角膜厚度(CCT)、前房深度(ACD)、IOL厚度、玻璃体深度(VL)及AL,放松状态下和调节状态下均测量2次,计算2次测量的重复性系数(COR)百分比;采用Bland-Altman一致性检验分析重复测量结果的一致性. 结果调节放松状态下2次重复测量的AL平均值为(23.241±0.882) mm,重复测量的差值为(-0.008±0.026)mm,2次重复测量比较差异无统计学意义(P=0.283);调节状态下2次重复测量的AL平均值为(23.274±0.889) mm,重复测量的差值为(0.002±0.028) mm,2次重复测量比较差异无统计学意义(P=0.724).调节过程中,AL较放松状态下增加约(32±35) μm.COR数值在放松状态和调节状态分别为0.222和0.240,COR％分别为1.03％和0.96％.一致性检验显示,各参数2次重复测量95％ LoA范围较窄,一致性良好. 结论 UL-OCT重复测量CCT、ACD、IOL厚度、VL及AL的可重复性良好,是观察IOL眼AL随调节变化的有用工具.
배경 조절시지인안위간청근물개변굴광력적능력,조절과정중안축장도(AL)적변화일직시연구난점. 목적 본연구중이용초장심도소묘OCT(UL-OCT)대인공정상체(IOL)안조절하AL변화적중복성진행평개,위연구안축변화여안조절적관계제공삼고. 방법 채용전첨성연구설계.납입2014년10월지2015년1월재온주의과대학부속안시광의원행백내장적출연합단초점IOL식입술적년령상관성백내장환자12례20안,년령56 ～ 84세,평균(69.9±7.6)세,용자주연발적UL-OCT경동공대방송상태혹조절상태하적전안도상진행박섭.UL-OCT광원중심파장위840 nm,축향분변솔위7μm,소묘심도위37.71 mm(공기중),채용자주개발설계연건대소득도상진행분석계산,획득중앙각막후도(CCT)、전방심도(ACD)、IOL후도、파리체심도(VL)급AL,방송상태하화조절상태하균측량2차,계산2차측량적중복성계수(COR)백분비;채용Bland-Altman일치성검험분석중복측량결과적일치성. 결과 조절방송상태하2차중복측량적AL평균치위(23.241±0.882) mm,중복측량적차치위(-0.008±0.026)mm,2차중복측량비교차이무통계학의의(P=0.283);조절상태하2차중복측량적AL평균치위(23.274±0.889) mm,중복측량적차치위(0.002±0.028) mm,2차중복측량비교차이무통계학의의(P=0.724).조절과정중,AL교방송상태하증가약(32±35) μm.COR수치재방송상태화조절상태분별위0.222화0.240,COR％분별위1.03％화0.96％.일치성검험현시,각삼수2차중복측량95％ LoA범위교착,일치성량호. 결론 UL-OCT중복측량CCT、ACD、IOL후도、VL급AL적가중복성량호,시관찰IOL안AL수조절변화적유용공구.
Background Accommodation is the ability of human eye to change refractive power to see near target clearly.Objective This study was to investigate the repeatability of imaging axial length (AL) under the pilocarpine-induced accommodation in pseudophakic patients using ultra-long scan depth OCT (UL-OCT).Methods A prospective study was carried out.Twenty eyes of 12 subjects who received monofocal intraocular lens (IOL)implantation were incuded in the Eye Hospital of Wenzhou Medical University from October 2014 to January 2015.The patients aged from 56 to 84 years (mean:[69.9±7.6] years).A self-built UL-OCT,with center wave length 840 nm and the axial resolution 7 μm and scan depth 37.71 mm (in the air), was employed to image the whole eye picture through the pupil in relax and accommodative states.The images were analyzed by a self-developed software to acquire the central corneal thickness (CCT), anterior chamber depth (ACD), IOL thickness, vitreous length (VL)and AL.The parameters were repeatly measured for two times, and the percentage of coefficient of repeatability (COR) was calculated.The consistency between the two measurements was evaluated by Bland-Altman agreement test.Results The average AL value was (23.241 ±0.882) mm,and the difference of repeated measurement values was (-0.008 ± 0.026)mm under the relax state, without statistical difference between two measurements (P=0.283).The average AL value was (23.274±0.889)mm, and the difference of repeated measurement values was (0.002±0.028)mm under the accommodation state, without statistical difference between two measurement values (P =0.724).AL increased by (32±35) μm after the accommodation.The CORs were 0.222 and 0.240, and the COR percentages were 1.03％ and 0.96％ under the relax condition and accommodation condition,respectively.The Bland-Altman plots showed that the mean differences between the two repeated measurement values were close to zero in the relax condition and accommodation condition.Conclusions UL-OCT is a potential tool of obtaining AL of whole eye in pseudophakic eyes.