Corneal Endothelium:A Promising Quantitative Index for Graves Ophthalmopathy Activity Evaluation.
Corneal Endothelium:A Promising Quantitative Index for Graves Ophthalmopathy Activity Evaluation.
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角膜内皮：格雷夫斯眼病活动评估的一个有前途的定量指标。
DOI：
10.1016/j.ajo.2021.05.020
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发表时间：
2021-06
影响因子：
4.2
通讯作者：
Pengxia Wan
中科院分区：
文献类型：
--
作者：
Min Zhou;Dide Wu;Fenfen Yu;Shubin Hong;Jiacheng Ye;Congyao Wang;Ye Li;Miao Du;Haipeng Xiao;Pengxia Wan
目的探讨格雷夫斯眼病（GO）的角膜内皮损伤及其作为评估GO活性的有前景的定量指标的作用。设计横断面研究。方法本研究包括64名GO患者的128只眼。所有受试者均接受眼科检查，包括眼球突出、泪膜破裂时间（BUT）、角膜荧光素染色和Schirmer试验。通过非接触式镜面显微镜测量角膜内皮，通过 IOLMaster 700 测量眼部生物特征参数。每只眼睛都被分配一个特定的临床活动评分（CAS），然后分为活动（CAS ≥ 3 分）或非活动（CAS < 3 分）。使用考虑眼间相关性的广义估计方程比较两组之间的眼部参数，并获得受试者工作特征（ROC）曲线。主要观察指标为角膜内皮参数。结果纳入眼中，81只眼患有非活动性GO，47只眼患有活动性GO。与非活动 GO 相比，活动 GO 中角膜内皮细胞形态发生了改变。与非活动 GO 相比，活动 GO 的细胞面积 (CV) 系数变异显着较高（37.0 [34.4-41.2]% vs 33.9 [30.9-36.8]%，P= .001），并且与 CAS 呈正相关（r = 0.322，P< .001）。此外，CV 显示出区分活动眼睛和不活动眼睛的诊断能力。 ROC曲线下面积为0.705。结论与非活性GO相比，活性GO的角膜内皮形态发生了变化。 CV是反映角膜内皮功能的敏感指标，有潜力成为评估GO患者活动状态的无创、客观、定量指标。
PurposeTo investigate the corneal endothelium damage in Graves ophthalmopathy (GO) and its role as a promising quantitative index to evaluate GO activity.DesignCross-sectional study.MethodsThis study included 128 eyes of 64 patients with GO. All subjects underwent ophthalmologic examinations, including proptosis, tear break-up time (BUT), corneal fluorescein staining, and Schirmer test. Corneal endothelium was measured by noncontact specular microscope and ocular biometric parameters were measured by IOLMaster 700. Each eye was assigned a specific clinical activity score (CAS), then grouped as active (CAS ≥3 points) or inactive (CAS <3 points). Ocular parameters between the 2 groups were compared using generalized estimating equations accounting for inter-eye correlation, and receiver operating characteristic (ROC) curves were also obtained. Main outcome measures were parameters of corneal endothelium.ResultsAmong the included eyes, 81 eyes had inactive GO and 47 eyes had active GO. Corneal endothelial cell morphology was altered in active GO compared with inactive GO. The coefficient variation of cell area (CV) was significantly higher in active GO compared with inactive GO (37.0 [34.4-41.2]% vs 33.9 [30.9-36.8]%,P= .001), and positively correlated with CAS (r = 0.322,P< .001). Moreover, CV showed a diagnostic capacity to differentiate the active eyes from inactive eyes. The area under the ROC curve was 0.705.ConclusionsActive GO had morphologic changes in corneal endothelium compared with inactive GO. CV is a sensitive indicator to reflect corneal endothelial function, and has the potential to be adopted as a noninvasive, objective, and quantitative index for evaluating the activity status of GO patients.