Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes.
Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes.
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DOI：
10.1016/j.ophtha.2012.06.023
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发表时间：
2012-12
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;Tan O;Brass R;Weiss JL;Huang D
利用傅里叶域光学相干断层扫描（OCT）绘制角膜上皮厚度图，并开发基于上皮厚度的圆锥角膜检测变量。横断面观察研究。76例正常人145只眼，22例角膜移植患者35只眼。采用轴向分辨率为5 μm的26,000 Hz傅里叶域OCT系统。以瞳孔为中心，采用“厚视仪+Cpwr”扫描模式（扫描直径6 mm， 8个径向，每个轴向扫描1024次，重复5次）对角膜进行成像。在一项前瞻性研究中，在一次访问中获得了三次扫描。开发了一种自动绘制角膜上皮厚度的计算机算法。计算了区域上皮厚度和5个诊断变量，包括最小值、优劣值（S-I）、最小值-最大值（MIN-MAX）、均方根变异值（RMSV）和均方根模式偏差（RMSPD）。测量的可重复性通过合并标准偏差进行评估。采用受试者工作特征曲线下面积（AROC）评价诊断准确性。区域性上皮厚度和诊断变量的描述性统计、可重复性和AROC。正常眼的中央、上、下上皮平均厚度分别为52.3±3.6、49.6±3.5、51.2±3.4 μm，角膜锥形眼的平均厚度分别为51.9±5.3、51.2±4.2、49.1±4.3 μm。与正常眼相比，角膜移植眼的下、最小角膜上皮厚度均显著降低（p = 0.03） （p < 0.0001）， S-I值更高（p = 0.013）， MIN-MAX值更高（p < 0.0001）， RMSV值更高（p < 0.0001）， RMSPD值更高（p < 0.0001）。纬向平均、最小、S-I、MIN-MAX上皮厚度变量的重复性在0.7 ~ 1.9 μm之间。RMSV的重复性优于0.4 μm。RMSPD的重复性在0.02以上。在所有基于上皮厚度的研究变量中，RMSPD提供了最好的诊断能力（AROC = 1.00）。仅使用RMSPD截止值0.057就可获得100%的特异性和100%的灵敏度。高分辨率傅里叶域OCT对正常和角膜锥形眼的角膜上皮厚度都有很好的重复性。圆锥角膜以顶端上皮变薄为特征。使用RMSPD变量可以非常准确地检测到与正常上皮模式的偏差。
To map the corneal epithelial thickness with Fourier-domain optical coherence tomography (OCT) and develop epithelial thickness-based variables for keratoconus detection. Cross-sectional observational study. One hundred forty-five eyes from 76 normal subjects and 35 keratoconic eyes from 22 patients. A 26,000 Hz Fourier-domain OCT system with 5-μm axial resolution was used. The cornea was imaged with a “Pachymetry+Cpwr” scan pattern (6-mm scan diameter, 8 radials, 1024 axial-scans each, repeated 5 times) centered on the pupil. Three scans were obtained at a single visit in a prospective study. A computer algorithm was developed to automatically map the corneal epithelial thickness. Zonal epithelial thicknesses and 5 diagnostic variables, including minimum, superior–inferior (S-I), minimum–maximum (MIN-MAX), root-mean-square variation (RMSV), and root-mean-square pattern deviation (RMSPD), were calculated. Repeatability of the measurements was assessed by the pooled standard deviation. The area under the receiver operating characteristic curve (AROC) was used to evaluate diagnostic accuracy. Descriptive statistics, repeatability, and AROC of the zonal epithelial thickness and diagnostic variables. The central, superior, and inferior epithelial thickness averages were 52.3±3.6, 49.6±3.5, and 51.2±3.4 μm in normal eyes and 51.9±5.3, 51.2±4.2 and 49.1±4.3 μm in keratoconic eyes. Compared to normal eyes, keratoconic eyes had significantly lower inferior (p = 0.03) and minimum corneal epithelial thickness (p < 0.0001), greater S-I (p = 0.013), more negative MIN-MAX (p < 0.0001), greater RMSV (p < 0.0001), and larger RMSPD (p < 0.0001). The repeatability of the zonal average, minimum, S-I, MIN-MAX epithelial thickness variables were between 0.7 to 1.9 μm. The repeatability of RMSV was better than 0.4 μm. The repeatability of RMSPD was 0.02 or better. Among all epithelial thickness based variables investigated, RMSPD provided the best diagnostic power (AROC = 1.00). Using a RMSPD cutoff value of 0.057 alone gave 100% specificity and 100% sensitivity. High-resolution Fourier-domain OCT mapped corneal epithelial thickness with good repeatability in both normal and keratoconic eyes. Keratoconus was characterized by apical epithelial thinning. The resulting deviation from the normal epithelial pattern could be detected with very high accuracy using the RMSPD variable.
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影响因子：
2.8
作者：
Li, Yan;Tang, Maolong;Zhang, Xinbo;Salaroli, Camila H.;Ramos, Jose L.;Huang, David
通讯作者：
Huang, David
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作者：
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Jester, JV
影响因子：
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作者：
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Amoils, PM
影响因子：
13.7
作者：
Li, Emmy Y. M.;Mohamed, Shaheeda;Lam, Dennis S. C.
通讯作者：
Lam, Dennis S. C.
影响因子：
13.7
作者：
Li, Y;Shekhar, R;Huang, D
通讯作者：
Huang, D