Keratoconus diagnosis with optical coherence tomography pachymetry mapping.
Keratoconus diagnosis with optical coherence tomography pachymetry mapping.
复制标题
圆锥角膜诊断具有光学相干断层扫描映射映射。
DOI：
10.1016/j.ophtha.2008.08.004
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发表时间：
2008-12
期刊：
影响因子：
13.7
通讯作者：
Huang D
中科院分区：
文献类型：
--
作者：
Li Y;Meisler DM;Tang M;Lu AT;Thakrar V;Reiser BJ;Huang D
使用高速眼前段光学相干断层扫描 (OCT) 测量的测厚图来检测圆锥角膜中的异常角膜变薄。横断面观察研究。 21 名受试者的 37 只圆锥角膜眼睛和 18 名正常受试者的 36 只眼睛。 OCT 系统在 1.3 μm 波长下运行，扫描速率为每秒 2000 次轴向扫描。使用以角膜顶点为中心的测厚扫描模式（8 个径向扫描，每个轴向扫描 128 个；直径 10 毫米）来绘制角膜厚度。厚度测量图按八分圆和圆环划分为多个区域。从 5 毫米直径内的区域计算五个厚度参数：最小值、最小值 - 中值、下 - 上 (I-S)、颞下 - 鼻上 (IT-SN) 和最薄角膜的垂直位置。正常组的 1 个百分位值用于定义诊断截止值。获得基于普拉西多环的角膜地形图用于比较。 OCT 厚度参数和定量圆锥角膜地形指数（角膜曲率、I-S、散光和偏斜百分比 [KISA%]）用于圆锥角膜诊断。诊断性能通过受试者工作特征（AROC）曲线下面积进行评估。圆锥形角膜更薄。圆锥角膜眼的厚度最小值平均为 452.6±60.9 μm，而正常眼为 546±23.7 μm。 1 百分位数截止值为 491.6 μm。最薄的位置在圆锥角膜中向下移位（-805±749 μm vs -118±260 μm；截止值，-716 μm）。变薄是局灶性的（最小-中值：-95.2±41.1 μm vs -45±7.7 μm；截止值，-62.6 μm）。圆锥角膜图更加不对称（I-S，-44.8±28.7 μm vs -9.9±9.3 μm；截止值，-31.3 μm；IT-SN，-63±35.7 μm vs -22±11.4 μm；截止值，-48.2 μm）。圆锥形眼睛的 KISA% 指数较高（2641±5024 vs 21±19）。所有差异均具有统计学意义（t 检验，P<0.0001）。应用低于圆锥角膜截止值的任何 1 OCT 厚度参数的诊断标准，得到的 AROC 为 0.99，略好于 KISA% 地形指数 (AROC，0.91) (P= .09)。光学相干断层扫描测厚图准确地检测到圆锥角膜眼中特征性的异常角膜变薄。该方法至少与地形 KISA 一样灵敏和特异。专有或商业披露可以在参考文献之后找到。
To detect abnormal corneal thinning in keratoconus using pachymetry maps measured by high-speed anterior segment optical coherence tomography (OCT). Cross-sectional observational study. Thirty-seven keratoconic eyes from 21 subjects and 36 eyes from 18 normal subjects. The OCT system operated at a 1.3 μm wavelength with a scan rate of 2000 axial scans per second. A pachymetry scan pattern (8 radials, 128 axial scans each; 10 mm diameter) centered at the corneal vertex was used to map the corneal thickness. The pachymetry map was divided into zones by octants and annular rings. Five pachymetric parameters were calculated from the region inside the 5 mm diameter: minimum, minimum–median, inferior–superior (I-S), inferotemporal–superonasal (IT-SN), and the vertical location of the thinnest cornea. The 1-percentile value of the normal group was used to define the diagnostic cutoff. Placido-ring–based corneal topography was obtained for comparison. The OCT pachymetric parameters and a quantitative topographic keratoconus index (keratometry, I-S, astigmatism, and skew percentage [KISA%]) were used for keratoconus diagnosis. Diagnostic performance was assessed by the area under the receiver operating characteristic (AROC) curve. Keratoconic corneas were thinner. The pachymetric minimum averaged 452.6±60.9 μm in keratoconic eyes versus 546±23.7 μm in normal eyes. The 1-percentile cutoff was 491.6 μm. The thinnest location was inferiorly displaced in keratoconus (−805±749 μm vs −118±260 μm ; cutoff, −716 μm). The thinning was focal (minimum–median: −95.2±41.1 μm vs −45±7.7 μm ; cutoff, −62.6 μm). Keratoconic maps were more asymmetric (I-S, −44.8±28.7 μm vs −9.9±9.3 μm ; cutoff, −31.3 μm ; and IT-SN, −63±35.7 μm vs −22±11.4 μm ; cutoff, −48.2 μm). Keratoconic eyes had a higher KISA% index (2641±5024 vs 21±19). All differences were statistically significant (t test, P<0.0001). Applying the diagnostic criteria of any 1 OCT pachymetric parameter below the keratoconus cutoff yielded an AROC of 0.99, which was marginally better (P= .09) than the KISA% topographic index (AROC, 0.91). Optical coherence tomography pachymetry maps accurately detected the characteristic abnormal corneal thinning in keratoconic eyes. This method was at least as sensitive and specific as the topographic KISA. Proprietary or commercial disclosure may be found after the references.
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