Naderan, M., Rajabi, M.T., Zarrinbakhsh, P.
期刊名称：The British journal of ophthalmology
角膜 圆锥 程度
摘要：背景/目的：旨在描述圆锥角膜（KC），疑似圆锥角膜（KCS）患者和正常参与者间的眼间不对称性，评估不对称性与疾病严重程度之间的关系。方法：在这项前瞻性观察比较研究中，双侧KC患者446例，双侧KCS患者68例，正常人306例，均接受Pentacam角膜曲率测量和角膜厚度测量以及屈光和视力检查。计算各参数组间的眼间不对称性，并进行组间比较。结果：KC组患者交叉按和较好眼之间的各项指标差异有统计学意义（P <0.05），而KCS组和正常组无显着性差异。正常组较差眼和较好眼指标没有观察到显著差异（p> 0.05）。与KCS组和正常组相比，KC组所有参数均有统计学明显差异（p <0.05）。 KC患者组内相关性差，KC患者中度至好，正常参与者相关性强。根据圆锥角膜严重度评分分类（p <0.05），所有参数的眼间不对称性与较差眼KC严重程度之间存在统计学显着相关性，其中基于圆锥角膜严重性评分分类，眼间不对称性随着疾病严重程度的增加而显着增加。根据受试者工作特征分析，眼间不对称可以有效区分正常眼KC和KCS。结论：KC是一种不对称性疾病，其不对称程度与疾病严重程度有关。在KC筛查中，应该对单眼非对称性进行单侧评估。
BACKGROUND/AIM:To describe the intereye asymmetry in patients with keratoconus (KC), keratoconus suspect (KCS) and normal participants, and to evaluate the relationship between asymmetry and disease severity.METHODS:In this prospective observational comparative study, 446 patients with bilateral KC, 68 patients with bilateral KCS and 306 normal participants underwent topographic, keratometric and pachymetric evaluations by Pentacam as well as refractive and visual acuity examinations. The intereye asymmetry in each parameter was calculated and compared between the groups.RESULTS:All parameters were significantly different between the worse and better eyes in the KC group (p<0.05), but not in the KCS and normal groups. No significant differences were observed in the measurements of the worse and better eyes of the normal group (p>0.05). There was a statistically significant greater intereye asymmetry in all parameters in the KC group compared with the KCS and normal groups (p<0.05). The intraclass correlations were poor in patients with KC, moderate to good in patients suspected with KC and strong in normal participants. There were statistically significant relationships between the intereye asymmetry in all parameters and KC severity in the worse eye in which intereye asymmetry significantly increased with an increase in disease severity, based on Keratoconus Severity Score classification (p<0.05). According to receiver operating characteristic analysis, the intereye asymmetry would effectively discriminate KC and KCS from normal eyes.CONCLUSION:KC is an asymmetric disease, and the degree of asymmetry is associated with disease severity. The analysis of intereye asymmetry should be performed along with unilateral evaluation in the screening of KC.