PDF(Pubmed)
Abstract：
Purpose: To explore stable and sensitive indicators for clinical diagnosis of acute angle closure (AAC) secondary to lens subluxation (LS) through quantitative analysis of CASIA 2 imaging.Design: A prospective cross-sectional study.
UNASSIGNED: Setting: Clinical practice.Participants: 23 patients with unilateral acute angle closure secondary to lens subluxation and 23 cataract patients without lens subluxation were recruited. Lens subluxation was confirmed by ultrasound biomicroscope diagnosis. The contralateral eyes without LS served as fellow control group. The cataract eyes without LS were enrolled in blank control group.Intervention: Participants underwent ophthalmologic examinations including slit-lamp biomicroscope, best corrected visual acuity, intraocular pressure, central corneal thickness measurement, axial length, gonioscopy, ultrasound biomicroscope and 360-degree anterior chamber and crystalline lens scan protocols of CASIA 2 system.Main outcome measures: Automated circumferential anterior segment and lens morphological parameters under anterior segment optical coherence tomography were analyzed via three-dimensional analysis.
UNASSIGNED: Significant differences were found in the front and back radius of the lens, the front and back radius of steep curvature of the lens, lens thickness, lens decentration, lens diameter, iris-trabecular contact (ITC) index, ITC area, anterior chamber depth (ACD), lens vault (LV), and iris volume between LS and controls. Among these parameters, LV, the anterior radius of steep curvature of the lens and ACD demonstrated the highest prediction power (AUC = 0.87, 0.89, and 0.86, respectively). The prediction power of tilt/axis was much higher in the Gaussian Naive Bayes model (AUCs = 0.90) than in the logistic model (AUCs = 0.74). Combination of LV_mean, LV_std, tilt and tilt axis in Gaussian Naive Bayes model presented as most stable and excellent diagnostic markers for AAC secondary to LS (AUCs = 0.98).
UNASSIGNED: The combination of markers including lens tilt and lens vault in the mathematic model facilitate clinical work as it not only provides novel diagnostic indications and possible prompt treatment for AAC secondary to lens subluxations, but also enhances our understanding of the pathogenic role of zonulopathy in angle closure glaucoma.
UNASSIGNED: Setting: Clinical practice.Participants: 23 patients with unilateral acute angle closure secondary to lens subluxation and 23 cataract patients without lens subluxation were recruited. Lens subluxation was confirmed by ultrasound biomicroscope diagnosis. The contralateral eyes without LS served as fellow control group. The cataract eyes without LS were enrolled in blank control group.Intervention: Participants underwent ophthalmologic examinations including slit-lamp biomicroscope, best corrected visual acuity, intraocular pressure, central corneal thickness measurement, axial length, gonioscopy, ultrasound biomicroscope and 360-degree anterior chamber and crystalline lens scan protocols of CASIA 2 system.Main outcome measures: Automated circumferential anterior segment and lens morphological parameters under anterior segment optical coherence tomography were analyzed via three-dimensional analysis.
UNASSIGNED: Significant differences were found in the front and back radius of the lens, the front and back radius of steep curvature of the lens, lens thickness, lens decentration, lens diameter, iris-trabecular contact (ITC) index, ITC area, anterior chamber depth (ACD), lens vault (LV), and iris volume between LS and controls. Among these parameters, LV, the anterior radius of steep curvature of the lens and ACD demonstrated the highest prediction power (AUC = 0.87, 0.89, and 0.86, respectively). The prediction power of tilt/axis was much higher in the Gaussian Naive Bayes model (AUCs = 0.90) than in the logistic model (AUCs = 0.74). Combination of LV_mean, LV_std, tilt and tilt axis in Gaussian Naive Bayes model presented as most stable and excellent diagnostic markers for AAC secondary to LS (AUCs = 0.98).
UNASSIGNED: The combination of markers including lens tilt and lens vault in the mathematic model facilitate clinical work as it not only provides novel diagnostic indications and possible prompt treatment for AAC secondary to lens subluxations, but also enhances our understanding of the pathogenic role of zonulopathy in angle closure glaucoma.
摘要：
目的:通过CASIA2影像定量分析,探讨稳定、敏感的临床诊断晶状体半脱位(LS)继发急性闭角(AAC)的指标。设计：前瞻性横断面研究。
■设置：临床实践。参与者：招募了23例继发于晶状体半脱位的单侧锐角闭合患者和23例无晶状体半脱位的白内障患者。超声生物显微镜诊断证实晶状体半脱位。没有LS的对侧眼睛作为对照组。无LS的白内障眼纳入空白对照组。干预：参与者接受了眼科检查，包括裂隙灯生物显微镜，最佳矫正视力，眼内压,中央角膜厚度测量,轴向长度,房角镜检查,CASIA2系统的超声生物显微镜和360度前房和晶状体扫描协议。主要结果指标：通过三维分析对眼前段光学相干断层扫描下的自动圆周眼前段和晶状体形态参数进行分析。
■在镜头的前后半径中发现了显着差异，镜头的曲率陡峭的前后半径，透镜厚度,透镜偏心,透镜直径,虹膜-小梁接触(ITC)指数,ITC区,前房深度（ACD），镜头拱顶（LV），LS和对照之间的虹膜体积。在这些参数中，LV,晶状体前陡曲率半径和ACD显示出最高的预测能力(AUC分别为0.87,0.89和0.86).在高斯朴素贝叶斯模型（AUC=0.90）中，倾斜/轴的预测能力远高于逻辑模型（AUC=0.74）。LV_平均值的组合，LV_std,高斯朴素贝叶斯模型中的倾斜和倾斜轴被认为是LS继发AAC的最稳定和出色的诊断标记（AUC=0.98）。
■数学模型中的包括晶状体倾斜和晶状体拱顶的标记组合促进了临床工作，因为它不仅为晶状体半脱位继发的AAC提供了新的诊断适应症和可能的及时治疗，同时也增强了我们对小带病在闭角型青光眼中的致病作用的认识。
■设置：临床实践。参与者：招募了23例继发于晶状体半脱位的单侧锐角闭合患者和23例无晶状体半脱位的白内障患者。超声生物显微镜诊断证实晶状体半脱位。没有LS的对侧眼睛作为对照组。无LS的白内障眼纳入空白对照组。干预：参与者接受了眼科检查，包括裂隙灯生物显微镜，最佳矫正视力，眼内压,中央角膜厚度测量,轴向长度,房角镜检查,CASIA2系统的超声生物显微镜和360度前房和晶状体扫描协议。主要结果指标：通过三维分析对眼前段光学相干断层扫描下的自动圆周眼前段和晶状体形态参数进行分析。
■在镜头的前后半径中发现了显着差异，镜头的曲率陡峭的前后半径，透镜厚度,透镜偏心,透镜直径,虹膜-小梁接触(ITC)指数,ITC区,前房深度（ACD），镜头拱顶（LV），LS和对照之间的虹膜体积。在这些参数中，LV,晶状体前陡曲率半径和ACD显示出最高的预测能力(AUC分别为0.87,0.89和0.86).在高斯朴素贝叶斯模型（AUC=0.90）中，倾斜/轴的预测能力远高于逻辑模型（AUC=0.74）。LV_平均值的组合，LV_std,高斯朴素贝叶斯模型中的倾斜和倾斜轴被认为是LS继发AAC的最稳定和出色的诊断标记（AUC=0.98）。
■数学模型中的包括晶状体倾斜和晶状体拱顶的标记组合促进了临床工作，因为它不仅为晶状体半脱位继发的AAC提供了新的诊断适应症和可能的及时治疗，同时也增强了我们对小带病在闭角型青光眼中的致病作用的认识。
