OPD-ScanⅢ与Pentacam测量角膜屈光力和散光的一致性

doi:10.3760/cma.j.cn115909-20200612-00253

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摘要目的：分析OPD-ScanⅢ与Pentacam测量角膜散光（CA）患者角膜屈光力、CA及散光轴位的相关性和一致性。方法：系列病例研究。收集2019年6─12月在苏州大学附属理想眼科医院就诊的屈光不正患者876例（1 072眼），分别用OPD-ScanⅢ与Pentacam测量角膜平坦轴屈光力（K1）、陡峭轴屈光力（K2）、CA、散光轴位、矢量参数J0（0°或180°轴位的Jackson交叉柱镜值）、45°轴位的Jackson交叉柱镜值（J45）。按Pentacam测量的CA度数分为低度CA组（CA≤0.75 D）301眼和高度CA组（CA>0.75 D） 771眼。选取2种仪器连续测量3次，选取散光轴位为中间值的那次测量数据用于统计分析。采用配对t检验或Wilcoxon检验，Spearman相关性分析及Bland-Altman分析法对2种仪器测量数据的差异性、相关性、一致性进行分析。结果：低度CA组中，OPD-ScanⅢ与Pentacam测量K1、K2及CA的差异均有统计学意义（t=4.991，P=0.001；Z=2.310，P=0.022；Z=-2.891，P=0.004）；2种仪器测量K1、K2、 CA、散光轴位、J0及J45的95%一致性界限（LOA）分别为（-0.31，0.35）D、（-0.32，0.42）D、（-0.32， 0.38）D、（-27.86，27.96）°、（-0.19，0.21）D和（-0.18，0.18）D。高度CA组中OPD-ScanⅢ与Pentacam 测量K1、K2、CA、散光轴位、J0 及J45 差异均有统计学意义（t=-10.763，P<0.001；t=6.046， P<0.001；Z=-2.335，P=0.020；Z=-5.480，P<0.001；Z=-1.997，P=0.046；Z=-6.079，P<0.001）；2种仪器测量K1、K2、CA、散光轴位、J0及J45的95%LOA分别为（-0.27，0.39）D、（-0.34，0.44）D、（-0.44， 0.42）D、（-11.15，13.55）°、（-0.25，0.23）D及（-0.25，0.33）D。在低度和高度CA组中OPD-ScanⅢ与 Pentacam测量的K1、K2、CA、散光轴位、J0及J45值均有相关性（均P<0.05）。结论：OPD-ScanⅢ测量K值和高度CA患者的散光轴位时与Pentacam的测量具有较高的一致性，但其测量CA度数和低度 CA患者散光轴位时与Pentacam测量值的一致性较差。

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关键词 ： , OPD-ScanⅢ, Pentacam, 角膜屈光力, 角膜散光, 散光轴位, 一致性

Abstract： Objective: To analyze the correlation and agreement of keratometry (K), corneal astigmatism (CA) and the axis measured by OPD-Scan III and Pentacam in patients with low or high CA. Methods: In this case series studies, 876 patients (1 072 eyes) with refractive errors, who were admitted to the Ideal Ophthalmology Hospital Affiliated to Soochow University, were recruited from June to December 2019. Patients were divided into low (301 patients) and high (771 patients) CA groups. Keratometry in the flattest axis (K1), keratometry in the steepest axis (K2), CA and axis, vector parameters J0 (the Jackson cross cylindrical values at 0° or 180°) and the Jackson cross cylindrical values at 45° (J45) were evaluated. The measurement results were analyzed, to show in which the axis was the median of the three successive measurements. A t-test or Wilcoxon test was used to assess differences. A Spearman correlation was used to assess correlations. The Bland-Altman method was used to assess agreement. Results: In the low CA group, the differences of K1, K2 and CA measured by OPD-Scan III and Pentacam were significant (t=4.991, P=0.001; Z=2.310, P=0.022; Z=-2.891, P=0.004). The 95% limits of agreement (LOA) of OPD-Scan III and Pentacam in measuring K1, K2, CA, axis, J0 and J45 were -0.31, 0.35 D, -0.32, 0.42 D, -0.32, 0.38 D, -27.86°, 27.96°, -0.19, 0.21 D and -0.18, 0.18 D, respectively. In the high CA group, the differences of K1, K2, CA, axis, J0 and J45 measured by OPD-Scan III and Pentacam were significant (t=-10.763, P<0.001; t=6.046, P<0.001; Z=-2.335, P=0.020; Z=-5.480, P<0.001; Z=-1.997, P=0.046; Z=-6.079, P<0.001). The 95%LOA of the OPD-Scan III and Pentacam in measuring K1, K2, CA, axis, J0 and J45 were -0.27, 0.39 D, -0.34, 0.44 D, -0.44, 0.42 D, -11.15°, 13.55°, -0.25, 0.23 D and -0.25, 0.33 D, respectively. There were significant correlations between the two devices in terms of K1, K2, CA and axis, J0 or J45 in both the low and high CA groups (all P<0.05). Conclusions: OPD-Scan III shows a high agreement with Pentacam in measuring keratometry and the axis in patients with high CA. However, its measurement of CA and the axis in patients with low CA has low agreement with Pentacam.

Key words： OPD-Scan III Pentacam keratometry corneal astigmatism axis of astigmatism agreement

收稿日期: 2020-06-12

PACS:

基金资助: 南通市卫生健康委员会课题项目（MB2019005）

通讯作者: 吴莹（ORCID：0000-0002-0460-3543），Email：wuyingeye@126.com

引用本文:

李盼盼1 袁幽2 涂园园2 宋愈1 吴莹1. OPD-ScanⅢ与Pentacam测量角膜屈光力和散光的一致性[J]. 中华眼视光学与视觉科学杂志, 2021, 23(5): 348-355. Panpan Li1,You Yuan2,Yuanyuan Tu2,Yu Song1,Ying Wu1. Agreement of OPD-Scan III with Pentacam in Measuring Keratometry and Astigmatism. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(5): 348-355. DOI: 10.3760/cma.j.cn115909-20200612-00253

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20200612-00253 或 https://www.cjoovs.com/CN/Y2021/V23/I5/348

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