视觉功能分析仪和扫频光学生物测量仪测量白内障患者Kappa角与Alpha角的比较

doi:10.3760/cma.j.cn115909-20200903-00355

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摘要目的：评价视觉功能分析仪和扫频光学生物测量仪测量白内障患者Kappa角和Alpha角的差异性、相关性、一致性和重复性。方法：系列病例研究。纳入2018年10月至2019年10月于武汉大学附属爱尔眼科医院拟进行白内障手术的164例患者，所有患者均选取其右眼数据进行分析。采用iTrace视觉功能分析仪和IOLMaster 700扫频光学生物测量仪采集患者的Kappa角、Alpha角、对应的瞳孔直径及角膜直径，每位患者均进行3次重复测量。采用配对t检验和Wilcoxon符号秩检验分析2种仪器测量结果的差异性。采用Pearson相关分析和Spearmen相关分析对2种仪器Kappa角和Alpha角的相关性进行分析。采用Bland-Altman法计算2种仪器测量Kappa角和Alpha角的一致性界限（95%LoA）。采用组内相关系数（ICC）分析2种仪器3次重复测量Kappa角和Alpha角的重复性。结果：iTrace测得的Kappa角、Alpha角、瞳孔直径及角膜直径分别为0.26（0.18，0.38）mm、（0.35±0.14）mm、4.70（4.22， 5.42）mm、（10.85±0.36）mm。IOLMaster 700测得的Kappa角、Alpha角、瞳孔直径及角膜直径分别为 0.23（0.15，0.34）mm、（0.42±0.19）mm、4.43（3.74，4.87）mm、（11.73±0.43）mm。2种仪器测得Alpha角、瞳孔直径及角膜直径比较差异有统计学意义（t=-5.541，P<0.001；Z=-9.117，P<0.001；t=-49.463， P<0.001），二者的Kappa角比较差异无统计学意义。iTrace、IOLMaster 700测得的Kappa角大于0.5 mm 的比例都为5.4%，测得的Alpha角大于0.5 mm的比例分别为14.0%、32.9%。iTrace和IOLMaster 700 测得的Kappa角、Alpha角均呈中等相关（ρ=0.607、r=0.553，均P<0.001）。2种仪器Kappa角、Alpha 角的95%LoA分别为0.0164（-0.3032～0.3361）mm、-0.0718（-0.3970～0.2534）mm。iTrace测量 Kappa角和Alpha角的ICC（95%CI）分别为0.771（0.689～0.832）、0.771（0.688～0.832），IOLMaster 700测量Kappa角和Alpha角的ICC（95%CI）分别为0.823（0.759～0.870）、0.863（0.814～0.899）。结论：iTrace视觉功能分析仪和IOLMaster 700扫频光学生物测量仪测量的Kappa角差异无统计学意义，但二者测量的瞳孔直径差异存在统计学意义，不可直接替代。二者测量的Alpha角存在显著差异， IOLMaster 700测得的Alpha角更大，2种仪器测得的Alpha角不能代替使用。

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关键词 ： , Kappa角, Alpha角, 扫频光学生物测量仪, iTrace视觉功能分析仪, 白内障

Abstract： Objective: To evaluate the difference, correlation, agreement and repeatability of angle kappa and angle alpha measured by a visual function analyzer and swept-source optical coherence tomography biometer. Methods: A series of case study was designed. One hundred sixty-four patients undergoing cataract surgery in our hospital from October 2018 to October 2019 were included. Data from their right eyes were selected for analysis in all patients. Angle kappa, angle alpha, and the corresponding pupil diameter and corneal diameter were measured by the iTrace visual function analyzer and IOLMaster 700 sweptsource optical coherence tomography biometer. Three repeated measurements were taken for each patient. A paired t test and Wilcoxon symbolic rank test were used to analyze the differences in measurement results. The Pearson correlation coefficient and Spearmen correlation coefficient were used to analyze the correlation. The 95% limits of agreement (LoA) of angle kappa and angle alpha measured by the two devices were calculated by the Bland-Altman method. The repeatability of angle kappa and angle alpha for the two devices was evaluated by the intraclass correlation coefficient (ICC). Results: The angle kappa, angle alpha, pupil diameter and corneal diameter were 0.26 mm (0.18, 0.38), 0.35±0.14 mm, 4.70 mm (4.22, 5.42) and 10.85±0.36 mm (iTrace), and were 0.23 mm (0.15, 0.34), 0.42±0.19 mm, 4.43 mm (3.74, 4.87) and 11.73±0.43 mm (IOLMaster 700), respectively. The angle kappas of the two devices showed no significant difference, while the angle alpha, pupil diameter and corneal diameter showed significant differences (t=-5.541, Z=-9.117, t=-49.463, all P<0.001). The angle kappa was above 0.5 mm in 5.4% of eyes in both devices. The angle alpha was above 0.5 mm in 14.0% (iTrace) versus 32.9% (IOLMaster 700) of eyes. The angle kappa and angle alpha measured by the two devices were moderately correlated (ρ=0.607, r=0.553, P<0.001). The 95%LoA of angle kappa and angle alpha of the two devices was 0.0164(-0.3032-0.3361 mm) and -0.0718(-0.3970-0.2534 mm), respectively. The ICC (95%CI) of angle kappa and angle alpha for iTrace was 0.771(0.689-0.832) and 0.771(0.688-0.832), respectively, and that of IOLMaster 700 was 0.823(0.759-0.870) and 0.863(0.814-0.899), respectively. Conclusions: Angle kappa measured by the two devices shows no difference. However, it is not directly interchangeable considering the difference in pupil diameter between the two devices. There is a significant difference in terms of angle alpha between the two devices, which is larger in IOLMaster 700. The angle alpha of iTrace is not directly interchangeable with that of IOLMaster 700.

Key words： angle kappa angle alpha swept-source optical coherence tomography biometer visual function analyzer cataract

收稿日期: 2020-09-03

PACS:

基金资助: 湖南省临床医疗技术创新引导计划（2018SK50109）；武汉市卫健委医学科研项目（WX17B22）；爱尔眼科医院集团科研基金项目（AM1902D1）

通讯作者: 王勇（ORCID：0000-0002-7645-9972），Email：wangyongeye@163.com

引用本文:

梁健恒1 冯希1 许雅利1 王勇1，2. 视觉功能分析仪和扫频光学生物测量仪测量白内障患者Kappa角与Alpha角的比较[J]. 中华眼视光学与视觉科学杂志, 2021, 23(2): 98-103. Jianheng Liang1,Xi Feng1,Yali Xu1,Yong Wang1, 2. Comparison of Angle Kappa and Angle Alpha When Measured by a Visual Function Analyzer and Swept-Source Optical Coherence Tomography Biometer in Cataract Patients. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(2): 98-103. DOI: 10.3760/cma.j.cn115909-20200903-00355

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20200903-00355 或 https://www.cjoovs.com/CN/Y2021/V23/I2/98

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