目的:回顾当前已发表的关于角膜滞后(CH)的效用的文献,以协助临床医生诊断青光眼或评估现有青光眼患者的疾病进展风险。
方法:对PubMed数据库中的同行评审文献进行了搜索,直到2022年7月。检查了423篇已确定的文章的摘要,以排除评论和非英语文章。在应用纳入和排除标准后,选择了19篇文章,小组方法学家对他们的证据水平进行了评级。八篇文章被评为一级,5篇被评为二级。被评为三级的6篇文章被排除在外。
结果:原发性开角型青光眼患者的角膜滞后较低,原发性闭角型青光眼,假性剥脱性青光眼,与正常人相比,假性剥脱综合征。由于这些参数对CH测量的影响,高眼压(IOP)或局部降压药物患者的低CH解释变得复杂。然而,CH在治疗初期也较低,正常眼压青光眼患者与具有相似眼压的正常人相比。此外,在开角型青光眼患者中,基于视野或结构标志物,较低的CH与青光眼进展风险增加相关,包括那些明显控制IOP的人。
结论:与正常人相比,青光眼患者的角膜滞后更低,较低的CH与疾病进展的风险增加有关。然而,因果关系还有待证明。然而,CH的测量在确定青光眼嫌疑人和患者的疾病风险方面补充了当前的结构和功能评估。
背景:专利或商业公开可以在参考文献之后找到。
To review the current published literature on the utility of corneal hysteresis (CH) to assist the clinician in the diagnosis of glaucoma or in the assessment of risk for disease progression in existing glaucoma patients.
Searches of the peer-reviewed literature in the PubMed database were performed through July 2022. The abstracts of 423 identified articles were examined to exclude reviews and non-English articles. After inclusion and exclusion criteria were applied, 19 articles were selected, and the panel methodologist rated them for level of evidence. Eight articles were rated level I, and 5 articles were rated level II. The 6 articles rated level III were excluded.
Corneal hysteresis is lower in patients with primary open-angle glaucoma, primary angle-closure glaucoma, pseudoexfoliative glaucoma, and pseudoexfoliation syndrome compared with normal subjects. Interpretation of low CH in patients with high intraocular pressure (IOP) or on topical hypotensive medications is complicated by the influence of these parameters on CH measurements. However, CH is also lower in treatment-naïve, normal-tension glaucoma patients compared with normal subjects who have a similar IOP. In addition, lower CH is associated with an increased risk of progression of glaucoma based on visual fields or structural markers in open-angle glaucoma patients, including those with apparently well-controlled IOP.
Corneal hysteresis is lower in glaucoma patients compared with normal subjects, and lower CH is associated with an increased risk of disease progression. However, a causal relationship remains to be demonstrated. Nevertheless, measurement of CH complements current structural and functional assessments in determining disease risk in glaucoma suspects and patients.
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