Evaluation of Multimodal Biometric Parameters for Diagnosing Acute Angle Closure Secondary to Lens Subluxation.
Evaluation of Multimodal Biometric Parameters for Diagnosing Acute Angle Closure Secondary to Lens Subluxation.
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DOI：
10.1007/s40123-022-00638-0
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发表时间：
2023-04
影响因子：
3.3
通讯作者：
Chen, Qin
中科院分区：
文献类型：
--
作者：
Chen, Xi;Song, Qinglu;Yan, Wen;Wang, Zijin;Cai, Bin;Zhang, Ying;Zhong, Hua;Chen, Qin
关键词：
目的：评价晶状体半脱位急性继发性闭角（ASAC-LS）、急性原发性闭角（APAC）和白内障患者的超声生物显微镜（UBM）和IOL的临床特征和多模态生物特征参数。本回顾性研究包括22眼ASAC-LS， 27眼APAC和39眼白内障。测量并比较三组患者的性别、年龄、患眼、最佳矫正视力、眼轴长度、角膜中央厚度、前房深度（ACD）。此外，我们比较了两种仪器测量的ACD比值（ACD ratio）和ACD差值（ACD difference）。采用Logistic回归分析评价晶状体半脱位的预测因素。绘制受试者工作特征（ROC）曲线，以获得合适的生物特征参数截断值，将ASAC-LS病例与APAC和白内障病例区分开来。在ASAC-LS组中，IOL Master测量的ACD中位数（四分位间距[IQR]）为2.47 (IQR 1.85-2.92) mm， UBM测量的ACD中位数为3.11 (IQR 2.60-3.76) mm。ASAC-LS组中两种仪器测量的ACD差异有统计学意义（P < 0.001），而APAC组（P = 0.521）和白内障组（P = 0.204）差异无统计学意义。随后的两两比较显示，ASAC-LS组仅ACD差（0.40 [IQR 0.22-1.08] mm）和ACD比值（1.18 [IQR 1.07-1.40]）与APAC组（ACD差0.02 [IQR 0.01-0.07] mm； ACD比值1.01 [IQR 1.00-1.04]）和白内障组（ACD差0.09 [IQR 0.01-0.14] mm； ACD比值1.03 [IQR 1.00-1.04]）差异有统计学意义（均P < 0.001）。多因素logistic回归分析显示，ACD差异和ACD比值与晶状体半脱位显著相关（P < 0.001和P = 0.001）。ROC曲线分析显示，ACD差值0.235 mm和ACD比值1.080分别为晶状体半脱位的临界值，敏感性为77.3%，特异性为100.0%。我们的发现为鉴别晶状体半脱位提供了新的选择。结合UBM的ACD和IOL Master可能有助于ASAC-LS的鉴别诊断。
To evaluate the clinical characteristics and multimodal biometric parameters from ultrasound biomicroscopy (UBM) and IOL Master biometry of patients with acute secondary angle-closure due to lens subluxation (ASAC-LS), acute primary angle-closure (APAC), and cataract. This retrospective study included 22 eyes with ASAC-LS, 27 eyes with APAC, and 39 eyes with cataract. Gender, age, affected eye, best corrected visual acuity, axial length, central corneal thickness, and anterior chamber depth (ACD) assessed by UBM and IOL Master were measured and compared between the three groups. In addition, we compared the ratio of ACD (ACD ratio) and the difference of ACD (ACD difference) measured by the two instruments. Logistic regression analysis was conducted to evaluate the predictive factors for lens subluxation. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of biometric parameters to separate ASAC-LS cases from APAC and cataract cases. In the ASAC-LS group, the median (interquartile range [IQR]) ACD measured by IOL Master was 2.47 (IQR 1.85–2.92) mm while the median ACD measured by UBM was 3.11 (IQR 2.60–3.76) mm. The difference of ACD measured by the two instruments was statistically significant in the ASAC-LS group (P < 0.001) whereas the differences were not statistically significant in the APAC group (P = 0.521) and cataract group (P = 0.204). Subsequent pairwise comparison revealed that only the ACD difference (0.40 [IQR 0.22–1.08] mm) and ACD ratio (1.18 [IQR 1.07–1.40]) in the ASAC-LS group were significantly different from those in the APAC group (ACD difference 0.02 [IQR 0.01–0.07] mm; ACD ratio 1.01 [IQR 1.00–1.04]) and cataract group (ACD difference 0.09 [IQR 0.01–0.14] mm; ACD ratio 1.03 [IQR 1.00–1.04]) (all P < 0.001). The ACD difference and ACD ratio were significantly associated with lens subluxation in the multivariate logistic regression analysis (P < 0.001 and P = 0.001, respectively). Additionally, the ROC curve analysis showed that the ACD difference at 0.235 mm and the ACD ratio at 1.080 were the respective cut-off values for lens subluxation, with a sensitivity of 77.3% and specificity of 100.0%. Our findings provide a new option for identifying lens subluxation. Specifically, combining the ACD from UBM and IOL Master may be helpful for differential diagnosis of ASAC-LS.
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4
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Lee RY;Kasuga T;Cui QN;Huang G;He M;Lin SC
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