Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis

IF 1.8 Q3 OPHTHALMOLOGY Clinical ophthalmology Pub Date : 2023-12-01 DOI:10.2147/opth.s436492
Sandra Owusu, Ebenezer Zaabaar, M. Kwarteng, Samuel Ankamah, John Baptist Vianney Abowine, S. Kyei
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Abstract

: Scheimpflug Pentacam Tomography is becoming crucial in the diagnosis and monitoring of keratoconus, as well as in pre-and post-corneal refractive care, but there are still some inconsistencies surrounding its evidence base diagnostic outcome. Therefore, this study aimed at employing meta-analysis to systematically evaluate the keratometric, pachymetric, and pachymetric progression indices used in the diagnosis of Keratoconus. The review protocol was registered with PROSPERO (Identifier: CRD4202310058) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, MEDLINE, Web of Science, and EMBASE were used for data search, followed by a quality appraisal of the included studies using the revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2). Meta-analysis was conducted using the meta (6.5.0) and metafor (4.2.0) packages in R version 4.3.0, as well as Stata. A total of 32 studies were included in the analysis. All keratometry (K) readings (flattest meridian, K1; steepest meridian, K2, maximum, Kmax) were significantly steeper in keratoconic compared to normal eyes: [MD (95% CI)], K1 [2.67 (1.81; 3.52)], K1-back [−0.71 (−1.03; −0.39)], K1-front [4.06 (2.48; 5.63)], K2 [4.32 (2.89; 5.75)], K2-back [−1.25 (−1.68; −0.82)], K2-front [4.82 (1.88; 7.76)], Kmax [7.57 (4.80; 10.34)], and Kmean [2.80 (1.13; 4.47)]. Additionally, corneal thickness at the center, CCT [−61.19 (−73.79; −48.60)] and apex, pachy-apex [−41.86 (−72.64; −11.08)] were significantly thinner in keratoconic eyes compared to normal eyes. The pooled estimates for pachymetric progression index (PPI): PPImin [0.66 (0.43; 0.90)], PPImax [1.26 (0.87; 1.64)], PPIavg [0.90 (0.68; 1.12)], and Ambrosio relational thickness (ART): ARTmax [−242.77 (−288.86; −196.69)], and ARTavg [−251.08 (−308.76; −195.39)] revealed significantly more rapid pachymetric progression in keratoconic eyes than in normal eyes. The Pentacam Scheimpflug-derived keratometric, pachymetric, and pachymetric progression indices are good predictors in discriminating KC from normal eyes.
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用于诊断角膜病的 Scheimpflug 衍生角膜测量、厚度测量和厚度进展指数:系统性回顾和元分析
:Scheimpflug Pentacam断层扫描在角膜病的诊断和监测以及角膜屈光治疗前后的护理中正变得越来越重要,但围绕其证据基础诊断结果仍存在一些不一致之处。因此,本研究旨在采用荟萃分析法对用于诊断角膜病的角膜度数、厚度和厚度进展指数进行系统评估。综述方案已在 PROSPERO 注册(标识符:CRD4202310058),并遵循了系统综述和荟萃分析首选报告项目(PRISMA)声明。使用 PubMed、MEDLINE、Web of Science 和 EMBASE 进行数据检索,然后使用诊断准确性研究质量评估修订工具 (QUADAS-2) 对纳入的研究进行质量评估。元分析使用 R 4.3.0 版的 meta(6.5.0)和 metafor(4.2.0)软件包以及 Stata 进行。共有 32 项研究被纳入分析。与正常眼相比,角膜炎患者的所有角膜度数(K)读数(最平子午线,K1;最陡子午线,K2;最大值,Kmax)都明显更陡:MD (95% CI)]、K1 [2.67 (1.81; 3.52)]、K1-back [-0.71 (-1.03; -0.39)]、K1-front [4.06 (2.48; 5.63)]、K2 [4.32 (2.89; 5.75)]、K2-back [-0.71 (-1.03; -0.39)]。75)]、K2-back [-1.25 (-1.68; -0.82)]、K2-front [4.82 (1.88; 7.76)]、Kmax [7.57 (4.80; 10.34)]和 Kmean [2.80 (1.13; 4.47)]。此外,与正常眼相比,角膜病变眼的角膜中心厚度 CCT [-61.19 (-73.79; -48.60)]和角膜顶点厚度 pachy-apex [-41.86 (-72.64; -11.08)]明显较薄。角膜厚度进展指数(PPI)的汇总估计值为PPImin[0.66(0.43;0.90)]、PPImax[1.26(0.87;1.64)]、PPIavg[0.90(0.68;1.12)]和 Ambrosio 关系厚度(ART)的集合估计值:ARTmax[-242.77(-288.86;-196.69)]和 ARTavg [-251.08(-308.76;-195.39)]显示,角膜病变眼的眼球厚度变化速度明显快于正常眼。Pentacam Scheimpflug 衍生的角膜测量、厚度测量和厚度进展指数是区分 KC 和正常眼的良好预测指标。
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来源期刊
Clinical ophthalmology
Clinical ophthalmology OPHTHALMOLOGY-
CiteScore
3.50
自引率
9.10%
发文量
499
审稿时长
16 weeks
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