全景超声生物显微镜和眼前节光学相干断层扫描在检测斜视患者内外直肌止端位置中的应用

doi:10.3760/cma.j.cn115909-20191021-00283

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Abstract Objective: To evaluate the feasibility and accuracy of panoramic ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) in measuring the distance of the limbus to the horizontal extraocular muscle (EOM) insertion in strabismus patients. Methods: This was a case series study. We compared the panoramic UBM and AS-OCT measurements of muscle insertions to the gold standard intraoperative measurement and to each other. The Friedman test, Mann-Whitney U test, Spearman's rank correlation, Kendall's coordination coefficient and Bland-Altman plots were used to analyze data. Results: A total of 133 unoperated horizontal muscles of 73 patients at Shenyang Aier Eye Hospital were measured from March 2018 to September 2018, and 72 lateral rectus muscles and 61 medial rectus muscles were analyzed. The mean limbus-insertion distances of the lateral rectus and medial rectus measured with UBM were 6.60(5.34-8.28)mm and 5.41(4.16-7.48)mm, with AS-OCT were 6.59(5.10- 8.80)mm and 5.17(3.44-7.41)mm, and with a caliper were 7.0(5.0-8.5)mm and 5.0(3.5-7.0)mm. When comparing the 3 methods for detecting unoperated muscles, there was no significant difference between them regarding limbus-insertion distance measurements except that both the UBM gave higher preoperative limbus-insertion distances for the medial rectus than the caliper (P=0.017). Spearman correlation analysis indicated that there were strong correlations between UBM and the caliper and AS-OCT and the caliper (r=0.656, P<0.001; r=0.608, P<0.001) and there was a medium correlation between UBM and AS-OCT measurements of the lateral rectus (r=0.530, P<0.001). There were medium correlations between UBM and the caliper, and AS-OCT and the caliper (r=0.597, P<0.001; r=0.458, P<0.001), and there was a weak correlation between UBM and AS-OCT measurements of the medial rectus (r=0.379, P=0.003). Kendall's nonparametric consistency test and the Bland-Altman diagram suggested good agreements between the three methods. Conclusions: Both the panoramic UBM and AS-OCT are sensitive tools in identifying horizontal rectus muscle insertions in primary strabismus surgeries.

Key words： panoramic ultrasound biomicroscopy anterior segment optical coherence tomography strabismus rectus muscle

Received: 21 October 2019

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Corresponding Authors: Jiwen Yang, Aier School of Ophthalmology, Central South University, Changsha 410015, China; Shenyang Aier Eye Hospital, Shenyang 110000, China (Email: yangjiwen1975@vip.163.com)

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