Subscribe to RSS
DOI: 10.1055/s-0029-1245776
© Georg Thieme Verlag KG Stuttgart · New York
Messung der zentralen Hornhautdicke mittels optischer Reflektometrie im Vergleich zur Ultraschall-Pachymetrie
Measurement of the Central Corneal Thickness using Optical Reflectometry and UltrasoundPublication History
Eingegangen: 8.8.2010
Angenommen: 21.9.2010
Publication Date:
23 March 2011 (online)
Zusammenfassung
Hintergrund: Bestimmung der zentralen Hornhautdicke mittels OLCR- und Ultraschallpachymetrie. Material und Methode: Retrospektive Beobachtungsstudie. Es werden 50 Patienten untersucht. Mittels „optical low coherence reflectometry (OLCR)” und konventioneller Ultraschalltechnik wird die zentrale Hornhautdicke gemessen. Ergebnisse: Das IOPac-System zeigte Werte für die zentrale Hornhautdicke zwischen 419 und 613 µm (Mittelwert 542,6 µm). Das OLCR-Gerät wies hier Werte zwischen 421 und 598 µm (Mittelwert 538,7 µm) auf. Der Variationskoeffizient betrug im Durchschnitt für das IOPac- 1,12 %, und für das OLCR-Gerät 0,97 %. Der gepaarte Student’s t-Test ergab keine signifikanten Unterschiede zwischen beiden Messverfahren bei glaukomatösen Augen; der p-Wert betrug 0,124. Ebenfalls zeigten beide Messtechniken bei einem r = 0,929 eine signifikante Korrelation. Schlussfolgerung: Die Übereinstimmung der Messwerte für die zentrale Hornhaudicke (gemessen mittels Ultraschall und OLCR) – eine korrekt durchgeführte Messung vorausgesetzt – ist hoch. Darüber hinaus benötigt das OLCR keine Lokalanästhesie und reduziert damit unter anderem das Infektionsrisiko. Besonders bei chirurgischen Fragestellungen und Glaukombeurteilungen müssen Bewegungsartefakte berücksichtigt werden, welche ggf. zu falschen Entscheidungen führen könnten.
Abstract
Aim: The aim of this study was to evaluate measurements of the central corneal thickness using OLCR and ultrasound pachymetry (IOPac). Materials and Methods: In a retrospective observational study, fifty patients were assessed. Central corneal thickness was measured using OLCR and ultrasound. Results: The IOPac system shows results for the central corneal thickness between 419 µm and 613 µm. The OLCR values ranged between 421 and 598 µm. The coefficient of variation was 1.12 % in the case of the IOPac and 0.97 % in the case of the OLCR. The paired Student’s t-test showed no significant differences between the two methods. The agreement between the two methods was high with r = 0.929. Conclusions: The agreement between the results for the central corneal thickness using OLCR and ultrasound is high. The OLCR is a non-touch technology that does not require local anaesthesia, thus further reducing the risk of infection or mechanical trauma. Especially in surgical applications or glaucoma assessments, movement artefacts need to be ruled out, which potentially could cause wrong values and thus lead to wrong decisions.
Schlüsselwörter
Kornea - physiologische Optik - Mikrobiologie
Key words
cornea - physiological optics - microbiology
Literatur
- 1 Doughty M J, Zaman M L. Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach. Surv Ophthalmol. 2000; 44 367-408
- 2 Gordon M O, Beiser J A, Brandt J D et al. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002; 120 714-720
- 3 Hagerb A, Dave H, Wiegand W. Corneal pachymetry and intraocular pressure. Klin Monatsbl Augenheilkd. 2005; 222 558-567
- 4 Jagow B, Kuhne C, Kohnen T. Central corneal thickness measurement with online optical coherence pachymetry and ultrasound pachymetry in 513 consecutive eyes. Klin Monatsbl Augenheilkd. 2009; 226 645-648
- 5 Kawana K, Miyata K, Tokunaga T et al. Central corneal thickness measurements using Orbscan II scanning slit topography, noncontact specular microscopy, and ultrasonic pachymetry in eyes with keratoconus. Cornea. 2005; 24 967-971
- 6 Chakrabarti H S, Craig J P, Brahma A et al. Comparison of corneal thickness measurements using ultrasound and Orbscan slit-scanning topography in normal and post-LASIK eyes. J Cataract Refract Surg. 2001; 27 1823-1828
- 7 Giraldez Fernandez M J, Diaz R ey A, Cervino A et al. A comparison of two pachymetric systems: slit-scanning and ultrasonic. Clao J. 2002; 28 221-223
- 8 Wong A C, Wong C C, Yuen N S et al. Correlational study of central corneal thickness measurements on Hong Kong Chinese using optical coherence tomography, Orbscan and ultrasound pachymetry. Eye. 2002; 16 715-721
- 9 Rainer G, Findl O, Petternel V et al. Central corneal thickness measurements with partial coherence interferometry, ultrasound, and the Orbscan system. Ophthalmology. 2004; 111 875-879
- 10 Gillis A, Zeyen T. Comparison of optical coherence reflectometry and ultrasound central corneal pachymetry. Bull Soc Belge Ophtalmol. 2004; 292 71-75
- 11 Barkana Y, Gerber Y, Elbaz U et al. Central corneal thickness measurement with the Pentacam Scheimpflug system, optical low-coherence reflectometry pachymeter, and ultrasound pachymetry. J Cataract Refract Surg. 2005; 31 1729-1735
- 12 Bohnke M, Chavanne P, Gianotti R et al. Continuous non-contact corneal pachymetry with a high speed reflectometer. J Refract Surg. 1998; 14 140-146
- 13 Genth U, Mrochen M, Walti R et al. Optical low coherence reflectometry for noncontact measurements of flap thickness during laser in situ keratomileusis. Ophthalmology. 2002; 109 973-978
- 14 Wong A C, Wong C C, Yuen N S et al. Correlational study of central corneal thickness measurements on Hong Kong Chinese using optical coherence tomography, Orbscan and ultrasound pachymetry. Eye. 2002; 16 715-721
- 15 Fishman G R, Pons M E, Seedor J A et al. Assessment of central corneal thickness using optical coherence tomography. J Cataract Refract Surg. 2005; 31 707-711
- 16 Muscat S, McKay N, Parks S et al. Repeatability and reproducibility of corneal thickness measurements by optical coherence tomography. Invest Ophthalmol Vis Sci. 2002; 43 1791-1795
- 17 Wirbelauer C, Scholz C, Hoerauf H et al. Noncontact corneal pachymetry with slit lamp-adapted optical coherence tomography. Am J Ophthalmol. 2002; 133 444-450
- 18 Suzuki S, Oshika T, Oki K et al. Corneal thickness measurements: scanning-slit corneal topography and noncontact specular microscopy versus ultrasonic pachymetry. J Cataract Refract Surg. 2003; 29 1313-1318
- 19 Rainer G, Petternel V, Findl O et al. Comparison of ultrasound pachymetry and partial coherence interferometry in the measurement of central corneal thickness. J Cataract Refract Surg. 2002; 28 2142-2145
- 20 Modis Jr L, Langenbucher A, Seitz B. Scanning-slit and specular microscopic pachymetry in comparison with ultrasonic determination of corneal thickness. Cornea. 2001; 20 711-714
- 21 Marsich M W, Bullimore M A. The repeatability of corneal thickness measures. Cornea. 2000; 19 792-795
- 22 Javaloy J, Vidal M T, Villada J R et al. Comparison of four corneal pachymetry technique’s in corneal refractive surgery. J Refract Surg. 2004; 20 29-34
- 23 Asensio I, Rahhal S M, Alonso L et al. Corneal thickness values before and after oxybuprocaine 0.4 % eye drops. Cornea. 2003; 22 527-532
- 24 Herse P, Siu A. Short-term effects of proparacaine on human corneal thickness. Acta Ophthalmol. 1992; 70 740-744
- 25 Ehlers N. The Precorneal Film. Biomicroscopical, Histological and Chemical Investigations. Acta Ophthalmol Suppl. 1965; Suppl 81 81-134
- 26 Mishima S. Some Physiological Aspects of the Precorneal Tear Film. Arch Ophthalmol. 1965; 73 233-241
- 27 Wang J, Fonn D, Simpson T L et al. Precorneal and pre- and postlens tear film thickness measured indirectly with optical coherence tomography. Invest Ophthalmol Vis Sci. 2003; 44 2524-2528
- 28 King-Smith P E, Fink B A, Fogt N et al. The thickness of the human precorneal tear film: evidence from reflection spectra. Invest Ophthalmol Vis Sci. 2000; 41 3348-3359
- 29 Pallikaris I G, Kymionis G D, Ginis H S et al. Ocular rigidity in living human eyes. Invest Ophthalmol Vis Sci. 2005; 46 409-414
1 Alle Autoren teilen sich die Erstautorschaft.
Dr. Alexander Scheuerle
Universitäts-Augenklinik Heidelberg
INF 400
69120 Heidelberg
Phone: ++ 49/62 21/56 66 04
Fax: ++ 49/62 21/56 54 22
Email: alexander.scheuerle@med.uni-heidelberg.de