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目的应用Pentacam三维眼前节分析系统分析早期圆锥角膜后表面形态的特点,为完善早期圆锥角膜形态特点的描述提供参考。方法选取亚临床期圆锥角膜患者(43人43眼),可疑圆锥角膜患者(40人40眼)及正常对照(143人143眼)。使用Pentacam三维眼前节分析系统检测角膜,统计分析后表面最大屈光度、后表面最大高度值、分布位置及各指标的组间差异,计算各指标的受试者工作曲线(ROC曲线,反映一项检测指标的敏感度和特异度)下面积。结果亚临床圆锥角膜组、可疑圆锥角膜组和正常组的平均后表面最大屈光度分别为-6.2 D,Q=0.5;-5.6 D,Q=0.3;-5.5 D,Q=0.3。平均后表面最大高度分别为23μm,Q=14;11μm,Q=8.5;7μm,Q=6。因数据分布为非正态分布,因而采用中位数和四分位间距表示法,Q代表四分位间距。后表面最大屈光度和后表面最大高度在各组之间均存在统计学意义的差别,且在前表面屈光度和高度出现异常前,后表面屈光度和高度已经发生改变。在诊断早期圆锥角膜中,后表面屈光度最大值、后表面高度最大值的ROC曲线下面积最大。结论基于Pentacam三维眼前节分析系统的检测结果,角膜后表面屈光度、后表面高度的变化是早期圆锥角膜形态改变的重要特点。
Objective To analyze the characteristics of posterior keratoconus posterior surface morphology by Pentacam three-dimensional anterior segment analysis system and provide reference for the improvement of the early keratoconus morphology description. Methods The patients with subclinical keratoconus (43 eyes 43 eyes), suspicious keratoconus (40 eyes 40 eyes) and normal controls (143 eyes 143 eyes) were selected. The Pentacam three-dimensional anterior segment analysis system was used to detect the cornea, and the maximum diopter, the maximum height of the posterior surface, the location of the posterior surface and the inter-group differences were calculated. The ROC curves of the subjects were calculated, Indicator sensitivity and specificity) under the area. Results The average maximum posterior refractive power in subclinical keratoconus group, suspicious keratoconus group and normal group were -6.2 D, Q = 0.5, -5.6 D, Q = 0.3, -5.5 D, Q = 0.3. The average back surface maximum heights were 23 μm, Q = 14; 11 μm, Q = 8.5; 7 μm, Q = 6, respectively. Due to the non-normal distribution of data distribution, so the median and quartile spacing representation, Q on behalf of quartiles. There was a statistically significant difference between the maximum refractivity of the posterior surface and the maximum height of the posterior surface, and the refraction and height of the posterior surface had changed before the anterior and posterior refractive errors and anomalies were observed. In the diagnosis of early keratoconus, the area under the ROC curve of the maximum value of posterior refractive power and the maximum value of posterior surface height is the largest. Conclusion Based on the results of the Pentacam 3D anterior segment analysis system, the changes of posterior corneal surface refraction and posterior surface height are important characteristics of the early keratoconus.