两种光学生物测量仪在中国青少年人群中应用的比较
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摘要
目的评估两种光学生物测量仪(Lenstar LS900~与SW-9000)对青少年眼球生物测量结果的重复性,并比较两种仪器测量值的一致性。方法采用前瞻性研究,纳入65例屈光不正患者,分别用SW-9000与Lenstar LS900~进行右眼眼球生物测量,应用单因素方差分析评估仪器的可重复性,应用Bland-Altman散点图对两种仪器测量值进行一致性评价。结果 Lenstar LS900~测量指标AL、K1、K2、CCT、AD、LT、PD的重复性良好,ICC均大于0.90;WTW略差,但仍大于0.88。SW-9000测量指标AL、K1、K2、CCT的重复性良好,ICC均大于0.9,其余参数重复性较差。将两种仪器重复性均良好的AL、K1、K2、CCT分别进行比较,发现SW-9000所测AL、CCT比Lenstar LS900~略长,且差异均有统计学意义(均为P<0.05);而K1、K2均无明显差异(均为P>0.05)。此外两种仪器间AL、K1、K2、CCT均存在密切的线性相关(均为r>0.97,均为P<0.01)。Bland-Altman散点图显示,两种仪器测量指标的95%Lo A分别为AL:-0.057~0.133 mm;K1:-0.456~0.369 D;K2:-0.388~0.549 D;CCT:-3.483~8.016μm。结论对于8~18岁青少年人群,Lenstar LS900~与SW-9000眼球生物测量指标(包括AL、K1、K2、CCT)均具有良好的重复性,SW-9000与Lenstar LS900~测量参数AL、K1、K2、CCT相关性高,且4个参数95%Lo A在临床上可接受,一致性良好。
Objective To evaluate the repeatability and agreement of two optical biometers( Lenstar LS900~ and SW-9000) for ocular biometry in Chinese adolescents. Methods A prospective study was conducted which included 65 ametropic patients,with an average age of( 11. 45 ± 2. 67) years( age ranging from 8 to 18 years). The ocular biometry for right eyeball was performed with Lenstar LS900~ and SW-9000 respectively,followed by evaluation of the repeatability of the two biometers using one-way analysis of variance,and the agreement of the two instruments using the Bland-Altman plot. Results The repeatability of parameters measured by Lenstar LS900~,including axial length( AL),K value in the flattest meridian( K1),K value in the steepest meridian( K2),central corneal thickness( CCT),anterior depth( AD),lens thickness( LT),pupil diameter( PD),was well,and all intraclass correlation coefficient( ICC) > 0. 9; the repeatability of white to white( WTW)was inferior to other parameters,but it was still > 0. 88. The repeatability of AL,K1,K2,CCT measured by SW-9000 was good,with their ICC > 0. 9,but the repeatability of other parameters was poor. The parameters with good repeatability including AL,K1,K2,CCT measured by SW-9000 and Lenstar LS900~ were compared respectively,and the results showed that AL and CCT examined by SW-9000 were slightly longer than those measured by Lenstar LS900~,and the difference was statistically significant( all P < 0. 05). However,there was no significant difference about K1,K2( all P > 0. 05). Moreover,the AL,K1,K2 and CCT measured by the two instruments had close linear correlation( all r > 0. 97,all P < 0. 01).The Bland-Altman plot showed that 95 % Lo A( limits of agreement) of AL was(-0. 057 to0. 133) mm,K1 was(-0. 456 to 0. 369) D,K2 was(-0. 388 to 0. 549) D and CCT was(-3. 483 to 8. 016) μm. Conclusion Biometric parameters including AL,K1,K2,CCT measured by Lenstar LS900~ and SW-9000 have good repeatability in the adolescents aged8-18 years and they are highly correlated; meanwhile,the agreement of AL,K1,K2,CCT measured by SW-9000 with Lenstar LS900~ is acceptable in clinical practices.
Objective To evaluate the repeatability and agreement of two optical biometers( Lenstar LS900~ and SW-9000) for ocular biometry in Chinese adolescents. Methods A prospective study was conducted which included 65 ametropic patients,with an average age of( 11. 45 ± 2. 67) years( age ranging from 8 to 18 years). The ocular biometry for right eyeball was performed with Lenstar LS900~ and SW-9000 respectively,followed by evaluation of the repeatability of the two biometers using one-way analysis of variance,and the agreement of the two instruments using the Bland-Altman plot. Results The repeatability of parameters measured by Lenstar LS900~,including axial length( AL),K value in the flattest meridian( K1),K value in the steepest meridian( K2),central corneal thickness( CCT),anterior depth( AD),lens thickness( LT),pupil diameter( PD),was well,and all intraclass correlation coefficient( ICC) > 0. 9; the repeatability of white to white( WTW)was inferior to other parameters,but it was still > 0. 88. The repeatability of AL,K1,K2,CCT measured by SW-9000 was good,with their ICC > 0. 9,but the repeatability of other parameters was poor. The parameters with good repeatability including AL,K1,K2,CCT measured by SW-9000 and Lenstar LS900~ were compared respectively,and the results showed that AL and CCT examined by SW-9000 were slightly longer than those measured by Lenstar LS900~,and the difference was statistically significant( all P < 0. 05). However,there was no significant difference about K1,K2( all P > 0. 05). Moreover,the AL,K1,K2 and CCT measured by the two instruments had close linear correlation( all r > 0. 97,all P < 0. 01).The Bland-Altman plot showed that 95 % Lo A( limits of agreement) of AL was(-0. 057 to0. 133) mm,K1 was(-0. 456 to 0. 369) D,K2 was(-0. 388 to 0. 549) D and CCT was(-3. 483 to 8. 016) μm. Conclusion Biometric parameters including AL,K1,K2,CCT measured by Lenstar LS900~ and SW-9000 have good repeatability in the adolescents aged8-18 years and they are highly correlated; meanwhile,the agreement of AL,K1,K2,CCT measured by SW-9000 with Lenstar LS900~ is acceptable in clinical practices.
引文
[1]LEE AC,QAZI MA,PEPOSE JS.Biometry and intraocular lens power calculation[J].Curr Opin Ophthalmol,2008,19(1):13-17.
[2]OLSEN T,ARNARSSON A,SASAKI H,SASAKI K,JONASSON F.On the ocular refractive components:the Reykjavik Eye Study[J].Acta Ophthalmol Scand,2007,85(4):361-366.
[3]OSUOBENI EP.Ocular components values and their intercorrelations in Saudi Arabians[J].Ophthalmic Physiol Opt,1999,19(6):489-497.
[4]GUO Y,LIU LJ,XU L,LV YY,TANG P,FENG Y,et al.Outdoor activity and myopia among primary students in rural and urban regions of Beijing[J].Ophthalmology,2013,120(2):277-283.
[5]SANTODOMINGO-RUBIDO J,VILLA-COLLAR C,GILMARTIN B,GUTIERREZ-ORTEGA R.Myopia control with orthokeratology contact lenses in Spain:refractive and biometric changes[J].Invest Ophthalmol Vis Sci,2012,53(8):5060-5065.
[6]HUA WJ,JIN JX,WU XY,YANG JW,JIANG X,GAO GP,et al.Elevated light levels in schools have a protective effect on myopia[J].Ophthalmic Physiol Opt,2015,35(3):252-262.
[7]ROHRER K,FRUEH BE,WALTI R,CLEMETSON IA,TAPPEINER C,GOLDBLUM D.Comparison and evaluation of ocular biometry using a new noncontact optical low-coherence reflectometer[J].Ophthalmology,2009,116(11):2087-2092.
[8]HOLZER MP,MAMUSA M,AUFFARTH GU.Accuracy of a new partial coherence interferometry analyser for biometric measurements[J].Br J Ophthalmol,2009,93(6):807-810.
[9]SHAMMAS HJ,HOFFER KJ.Repeatability and reproducibility of biometry and keratometry measurements using a noncontact optical low-coherence reflectometer and keratometer[J].Am J Ophthalmol,2012,153(1):55-61.
[10]LACKNER B,SCHMIDINGER G,PIEH S,FUNOVICS MA,SKORPIK C.Repeatability and reproducibility of central corneal thickness measurement with Pentacam,Orbscan,and ultrasound[J].Optom Vis Sci,2005,82(10):892-899.
[11]HUANG J,LIAO N,SAVINI G,LI Y,BAO F,YU Y,et al.Measurement of central corneal thickness with optical low-coherence reflectometry and ultrasound pachymetry in normal and post-femtosecond laser in situ keratomileusis eyes[J].Cornea,2015,34(2):204-208.
[12]GOBBE M,GUILLON M,MAISSA C.Measurement repeatability of corneal aberrations[J].J Refract Surg,2002,18(5):S567-571.
[13]BLAND JM,ALTMAN DG.Statistical methods for assessing agreement between two methods of clinical measurement[J].Lancet,1986,1(8476):307-310.
[14]JASVINDER S,KHANG TF,SARINDER KK,LOO VP,SUBRAYAN V.Agreement analysis of LENSTAR with other techniques of biometry[J].Eye(Lond),2011,25(6):717-724.
[15]SAHIN A,GURSOY H,BASMAK H,YILDIRIM N,USALP Z,COLAK E.Reproducibility of ocular biometry with a new noncontact optical low-coherence reflectometer in children[J].Eur J Ophthalmol,2011,21(2):194-198.
[16]沈沛阳,丁小虎,钟兴武,陈海波,邢健强,何明光.两种光学生物测量仪在中国学龄期儿童中应用的比较[J].国际眼科杂志,2014,14(11):1921-1926.SHEN PY,DING XH,ZHONG XW,CHEN HB,XING JQ,HE MG.Comparison of two optical biometers in Chinese school-aged children[J].Int Eye Sci,2014,14(11):1921-1926.
[17]HOFFER KJ,SHAMMAS HJ,SAVINI G.Comparison of 2 laser instruments for measuring axial length[J].J Cataract Refract Surg,2010,36(4):644-648.
[18]HAIGIS W,LEGE B,MILLER N,SCHNEIDER B.Comparison of immersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis[J].Graefes Arch Clin Exp Ophthalmol,2000,238(9):765-773.
[19]MCALINDEN C,KHADKA J,PESUDOVS K.Statistical methods for conducting agreement(comparison of clinical tests)and precision(repeatability or reproducibility)studies in optometry and ophthalmology[J].Ophthalmic Physiol Opt,2011,31(4):330-338.
[20]GULER E,KULAK AE,TOTAN Y,YUVARLAK A,HEPSEN IF.Comparison of a new optical biometry with an optical low-coherence reflectometry for ocular biometry[J].Cont Lens Anterior Eye,2016,39(5):336-341.
[21]OLSEN T.Calculation of intraocular lens power:a review[J].Acta Ophthalmol Scand,2007,85(5):472-485.
[2]OLSEN T,ARNARSSON A,SASAKI H,SASAKI K,JONASSON F.On the ocular refractive components:the Reykjavik Eye Study[J].Acta Ophthalmol Scand,2007,85(4):361-366.
[3]OSUOBENI EP.Ocular components values and their intercorrelations in Saudi Arabians[J].Ophthalmic Physiol Opt,1999,19(6):489-497.
[4]GUO Y,LIU LJ,XU L,LV YY,TANG P,FENG Y,et al.Outdoor activity and myopia among primary students in rural and urban regions of Beijing[J].Ophthalmology,2013,120(2):277-283.
[5]SANTODOMINGO-RUBIDO J,VILLA-COLLAR C,GILMARTIN B,GUTIERREZ-ORTEGA R.Myopia control with orthokeratology contact lenses in Spain:refractive and biometric changes[J].Invest Ophthalmol Vis Sci,2012,53(8):5060-5065.
[6]HUA WJ,JIN JX,WU XY,YANG JW,JIANG X,GAO GP,et al.Elevated light levels in schools have a protective effect on myopia[J].Ophthalmic Physiol Opt,2015,35(3):252-262.
[7]ROHRER K,FRUEH BE,WALTI R,CLEMETSON IA,TAPPEINER C,GOLDBLUM D.Comparison and evaluation of ocular biometry using a new noncontact optical low-coherence reflectometer[J].Ophthalmology,2009,116(11):2087-2092.
[8]HOLZER MP,MAMUSA M,AUFFARTH GU.Accuracy of a new partial coherence interferometry analyser for biometric measurements[J].Br J Ophthalmol,2009,93(6):807-810.
[9]SHAMMAS HJ,HOFFER KJ.Repeatability and reproducibility of biometry and keratometry measurements using a noncontact optical low-coherence reflectometer and keratometer[J].Am J Ophthalmol,2012,153(1):55-61.
[10]LACKNER B,SCHMIDINGER G,PIEH S,FUNOVICS MA,SKORPIK C.Repeatability and reproducibility of central corneal thickness measurement with Pentacam,Orbscan,and ultrasound[J].Optom Vis Sci,2005,82(10):892-899.
[11]HUANG J,LIAO N,SAVINI G,LI Y,BAO F,YU Y,et al.Measurement of central corneal thickness with optical low-coherence reflectometry and ultrasound pachymetry in normal and post-femtosecond laser in situ keratomileusis eyes[J].Cornea,2015,34(2):204-208.
[12]GOBBE M,GUILLON M,MAISSA C.Measurement repeatability of corneal aberrations[J].J Refract Surg,2002,18(5):S567-571.
[13]BLAND JM,ALTMAN DG.Statistical methods for assessing agreement between two methods of clinical measurement[J].Lancet,1986,1(8476):307-310.
[14]JASVINDER S,KHANG TF,SARINDER KK,LOO VP,SUBRAYAN V.Agreement analysis of LENSTAR with other techniques of biometry[J].Eye(Lond),2011,25(6):717-724.
[15]SAHIN A,GURSOY H,BASMAK H,YILDIRIM N,USALP Z,COLAK E.Reproducibility of ocular biometry with a new noncontact optical low-coherence reflectometer in children[J].Eur J Ophthalmol,2011,21(2):194-198.
[16]沈沛阳,丁小虎,钟兴武,陈海波,邢健强,何明光.两种光学生物测量仪在中国学龄期儿童中应用的比较[J].国际眼科杂志,2014,14(11):1921-1926.SHEN PY,DING XH,ZHONG XW,CHEN HB,XING JQ,HE MG.Comparison of two optical biometers in Chinese school-aged children[J].Int Eye Sci,2014,14(11):1921-1926.
[17]HOFFER KJ,SHAMMAS HJ,SAVINI G.Comparison of 2 laser instruments for measuring axial length[J].J Cataract Refract Surg,2010,36(4):644-648.
[18]HAIGIS W,LEGE B,MILLER N,SCHNEIDER B.Comparison of immersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis[J].Graefes Arch Clin Exp Ophthalmol,2000,238(9):765-773.
[19]MCALINDEN C,KHADKA J,PESUDOVS K.Statistical methods for conducting agreement(comparison of clinical tests)and precision(repeatability or reproducibility)studies in optometry and ophthalmology[J].Ophthalmic Physiol Opt,2011,31(4):330-338.
[20]GULER E,KULAK AE,TOTAN Y,YUVARLAK A,HEPSEN IF.Comparison of a new optical biometry with an optical low-coherence reflectometry for ocular biometry[J].Cont Lens Anterior Eye,2016,39(5):336-341.
[21]OLSEN T.Calculation of intraocular lens power:a review[J].Acta Ophthalmol Scand,2007,85(5):472-485.