Javascript kuri ubu irahagarikwa muri mushakisha yawe.Bimwe mubiranga uru rubuga ntabwo bizakora niba JavaScript ihagaritswe.
Andika amakuru yawe yihariye nibiyobyabwenge byihariye kandi tuzahuza amakuru utanga ningingo ziva mububiko bwagutse kandi twohereze imeri kopi ya PDF ako kanya.
Ibe Ribeiro M., Barbosa C., Correia P., Torrao L., Neves Cardoso P., Moreira R., Falcao-Reis F., Falcao M., Pinheiro-Costa J.
Margarida Ribeiro, 1,2, *Margarita Ribeiro, 1.2 *Claudia Barbosa, imyaka 3 *Claudia Barbosa, imyaka 3 *Ishami ry'ubuvuzi 2 Bio - Ishami ry'ubuvuzi rya kaminuza ya Porto, Porto, Porutugali Ishami ry'ubuvuzi rya kaminuza ya Porto, Porto, Porutugali;4Ishami rishinzwe kubaga na Physiologiya, ishami ry'ubuvuzi, kaminuza ya Porto, Porto, PorutugaliIshami rishinzwe kubaga na Physiologiya, ishami ry'ubuvuzi, kaminuza ya Porto, Porto, Porutugali * Aba banditsi bagize uruhare runini muri iki gikorwa.Hernâni Monteiro Porto, 4200-319, Portigale, imeri ubwayo yakoreshejwe nkibintu bishya bya tomografi kugirango yandike iterambere ryagutse kandi ugereranije nibipimo byizewe byanyuma bya keratoconus (KK).Ibisubizo.Twasuzumye indangagaciro ya Kmax, D, radiyo yinyuma ya curvature, hamwe nokugabanuka kwiza kuva kuri 3.0 mm yoroheje cyane yibanze (PRC), EleBmax, BFSBR, na AdjEleBmax nkibipimo byigenga kugirango twandike iterambere rya KC (bisobanurwa nkibihinduka bibiri cyangwa byinshi), twabonye sensitivitivite ya 70%, 82%, 79%, 65%, 51%, na 63%, na 91%, 98%, 80%, 73%, 80%, na 84% byihariye kugirango bamenye iterambere rya KC..Agace kari munsi yu murongo (AUC) kuri buri gihinduka ni 0.822, 0.927, 0.844, 0.690, 0.695, 0,754.Umwanzuro: Ugereranije na EleBmax nta gihindutse, AdjEleBmax ifite umwihariko wo hejuru, AUC yo hejuru kandi ikora neza hamwe na sensibilité isa.AUC.Kubera ko imiterere yinyuma yinyuma iringaniye kandi igoramye kuruta ubuso bwimbere, bushobora gufasha kumenya impinduka, turasaba ko harimo AdjEleBmax mugusuzuma iterambere rya KC hamwe nibindi bihinduka kugirango tunonosore kwizerwa ryisuzuma ryamavuriro no gutahura hakiri kare.amajyambere. Amagambo y'ingenzi: keratoconus, cornea, gutera imbere, imiterere myiza ya dorsal nziza, uburebure ntarengwa bwubuso bwinyuma bwa cornea.
Keratoconus (KK) ni ectasia yibanze ya corneal yibanze.Ubu ifatwa nkindwara zombi (nubwo zidafite asimmetrike) zigenda zitera imbere ziganisha ku mpinduka nyinshi zuburyo zikurikirwa no kunanuka no gukomeretsa.1,2 Mubuvuzi, abarwayi bagaragaza astigmatisme idasanzwe na myopiya, Photophobia, na / cyangwa diplomopiya monocular bafite ubumuga bwo kutabona, bakosowe cyane (ACVA) kandi bikagabanya ubuzima bwiza.3,4 Kugaragara kwa RP mubisanzwe bitangira mumyaka icumi ya kabiri yubuzima no gutera imbere kugeza kumyaka icumi ya kane, bigakurikirwa no kuvura indwara.Ibyago nigipimo cyiterambere kiri hejuru kubantu barengeje imyaka 19.5.6
Nubwo nta muti ufatika uhari, ubuvuzi bwa none bwa ocular keratoconus bufite intego ebyiri zingenzi: kunoza imikorere yibikorwa no guhagarika iterambere ryagutse.7,8 Iyambere irashobora kugaragara mubirahuri, ibyuma bikomeye cyangwa igice cyo guhuza imiyoboro, impeta zo mu nda, cyangwa no guhinduranya corneal mugihe indwara ikabije.9 Intego yanyuma ni grail yera yubuvuzi bwabarwayi, kuri ubu bigerwaho gusa binyuze mu guhuza.Iki gikorwa kiganisha ku kwiyongera kwa biomechanical resistance hamwe no gukomera kwa cornea kandi bikarinda gutera imbere.10-13 Nubwo ibi bishobora gukorwa murwego urwo arirwo rwose rwindwara, inyungu nini iboneka mubyiciro byambere.14 Hagomba gushyirwaho ingufu kugirango hamenyekane iterambere hakiri kare kandi hirindwe ko iyangirika ryangirika, no kwirinda kuvurwa bitari ngombwa by’abandi barwayi, bityo bikagabanya ibyago byo guhura n’ibibazo nko kwandura, gutakaza ingirabuzimafatizo, ndetse n’ububabare bukabije nyuma yo kubagwa.15.16
Nubwo ubushakashatsi butandukanye bugamije gusobanura no kumenya iterambere, 17-19 haracyari ibisobanuro bihamye byerekana iterambere ryagutse cyangwa uburyo busanzwe bwo kubyandika.9,20,21 Mu bwumvikane bw’isi yose ku ndwara ya Keratoconus n’indwara zagutse (2015), iterambere rya keratoconus risobanurwa nkimpinduka zikurikiranye byibuze byibuze bibiri mubice bikurikira byerekana imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere y’imiterere: ya cornea Igipimo cyimpinduka cyiyongera kuva kuri perimetero kugera kumurongo muto.9 Ariko, ibisobanuro birambuye byiterambere biracyakenewe.Hashyizweho ingufu zo gushakisha impinduka zikomeye zo kumenya no gusobanura iterambere.19: 22-24
Urebye ko imiterere yinyuma ya corneal yinyuma, iringaniye kandi igoramye kuruta hejuru yimbere, irashobora kuba ingirakamaro mugutahura impinduka, 25 intego nyamukuru yubu bushakashatsi kwari ugusuzuma ibiranga impagarike ndende ya corneal hejuru.yahujwe n'akarere kamwe gakwiye.Ibipimo by'ibipimo (BFSB) (AdjEleBmax) na radiyo ya BFSB (BFSBR) byonyine byabaye ibipimo bishya kugirango byandike iterambere ryagutse kandi ubigereranya n'ibipimo bikoreshwa cyane bikoreshwa mu iterambere rya KC.
Amaso 113 y’abarwayi 76 bakurikiranye basuzumwe na keratoconus yasuzumwe muri ubu bushakashatsi bw’imyororokere mu ishami ry’ubuvuzi bw’amaso mu bitaro bikuru bya kaminuza ya São João, Porutugali.Ubushakashatsi bwemejwe na komite ishinzwe imyitwarire yaho muri Centro Hospitalar Universitário de São João / Faculdade de Medicina da Universidade do Porto kandi yakozwe hakurikijwe Itangazo rya Helsinki.Uruhushya rwanditse rwabonetse kubitabiriye amahugurwa bose, kandi niba abitabiriye amahugurwa bari munsi yimyaka 16, kubabyeyi na / cyangwa umurera wemewe.
Abarwayi bafite KC bafite hagati yimyaka 14 na 30 baramenyekanye kandi bikurikiranwa mubyiciro byacu byo gukurikirana amaso na corneal mu Kwakira-Ukuboza 2021.
Abarwayi bose batoranijwe bakurikiranwe umwaka umwe ninzobere ya corneal kandi bapimwe byibura bitatu bya Scheimpflug tomografiya (Pentacam®; Oculus, Wetzlar, Ubudage).Abarwayi bahagaritse kwambara lens byibura amasaha 48 mbere yo gupimwa.Ibipimo byose byakozwe na orthopediste watojwe kandi scan gusa ifite igenzura ryiza rya "OK" yarimo.Niba isuzuma ryikora ryikora ryikora ridashyizweho ikimenyetso nka "OK", ikizamini kizasubirwamo.Isuzuma ryibiri kuri buri jisho ryasesenguwe kugirango hamenyekane iterambere, buri jambo ryatandukanijwe namezi 12 ± 3.Amaso afite subclinical KC nayo yarimo (muribi bihe, irindi jisho rigomba kuba ryerekanye ibimenyetso bigaragara byubuvuzi KC).
Twakuyemo isesengura amaso ya KC yari yarigeze kubagwa amaso (corneal crosslinking, impeta ya corneal, cyangwa transplant corneal transplant) n'amaso afite indwara zateye imbere cyane (umubyimba wa corneal kuri thin <350 µm, hydrokeratose, cyangwa inkovu ndende) nkuko itsinda ryananiwe kunanirwa. "Nibyiza" nyuma yo kugenzura ubuziranenge bwimbere.
Amakuru ya demokarasi, ivuriro na tomografi yakusanyijwe kugirango asesengurwe.Kugirango tumenye iterambere rya KC, twakusanyije impinduka nyinshi za tomografiya zirimo corneal curvature ntarengwa (Kmax), bivuze ko corneal curvature (Km), meridional corneal curvature (K1), meridional corneal curvature (K2), astigmatism ya corneal (Astig = K2 - K1) ).). (AdjEleBmax).Nkuko bigaragara ku gishushanyo.1, AdjEleBmax iboneka nyuma yo kumenya intoki radiyo imwe ya BFSB mubizamini byimashini zombi dukoresheje agaciro ka BFSR duhereye kubigereranyo bya kabiri.
Umuceri.1. Kugereranya amashusho ya Pentacam® mumwanya uhagaze neza hamwe niterambere ryukuri ryamavuriro hamwe namezi 13 hagati y'ibizamini.Mu gice cya 1, EleBmax yari 68 µm mu kizamini cya mbere na 66 µm ku cya kabiri, bityo rero nta terambere ryagaragaye muri iki kintu.Umwanya mwiza wa radiyo ihita itangwa na mashini kuri buri suzuma ni 5.99 mm na 5.90 mm.Niba dukanze kuri buto ya BFS, idirishya rizagaragara aho radiyo nshya ya BFS ishobora gusobanurwa nintoki.Twagennye radiyo imwe mubizamini byombi dukoresheje BFS ya kabiri yapimwe agaciro (5.90mm).Mu gice cya 2, agaciro gashya ka EleBmax (EleBmaxAdj) gakosowe kuri BFS imwe mu isuzuma ryambere ni 59 µm, byerekana ko 7 µm yiyongereye mu isuzuma rya kabiri, byerekana iterambere ukurikije igipimo cya 7 µm.
Gusesengura iterambere no gusuzuma imikorere yimihindagurikire mishya yo kwiga, twakoresheje ibipimo bisanzwe bikoreshwa nkibimenyetso byiterambere (Kmax, Km, K2, Astig, PachyMin, PRC, na D-Index) kimwe nimbibi zasobanuwe mubitabo.nubwo atari mu buryo bwuzuye).Imbonerahamwe 1 irerekana indangagaciro zerekana iterambere rya buri kintu cyo gusesengura.Iterambere rya KC ryasobanuwe mugihe byibuze bibiri mubyahinduwe byemejwe gutera imbere.
Imbonerahamwe 1 Ibipimo bya Tomografiya byemewe nkibimenyetso byiterambere ryiterambere rya RP hamwe nibipimo bihuye byasobanuwe mubitabo (nubwo bitaremezwa)
Muri ubu bushakashatsi, imikorere yibihinduka bitatu yageragejwe kugirango itere imbere (EleBmax, BFSB, na AdjEleBmax) hashingiwe ku kuba hari iterambere byibuze byibuze bibiri bihinduka.Ingingo nziza yo guca kuri izi mpinduka zabazwe kandi ugereranije nizindi mpinduka.
Isesengura mibare ryakozwe hifashishijwe porogaramu y'ibarurishamibare ya SPSS (verisiyo 27.0 ya Mac OS; SPSS Inc, Chicago, IL, USA).Icyitegererezo kiranga incamake hamwe namakuru yatanzwe nkumubare nigipimo cyimpinduka zitandukanye.Ibihinduka bikomeza bisobanurwa nkibisobanuro kandi bitandukanijwe (cyangwa urwego rwagati kandi rwuzuzanya mugihe ikwirakwizwa ryagabanijwe).Guhindura indangantego ya keratometric yabonetse mugukuramo agaciro kambere uhereye kubipimo bya kabiri (nukuvuga, agaciro keza ka delta kerekana kwiyongera kwagaciro kubintu runaka).Ibizamini bya Parametric na non-parametric byakozwe kugirango hasuzumwe ikwirakwizwa rya corneal curvature variable yashyizwe mubikorwa cyangwa bitera imbere, harimo kwigenga-sample t-test, Mann-Whitney U-test, ikizamini cya chi-kare, hamwe na Fisher ikizamini nyacyo (niba bikenewe).Urwego rw'ibarurishamibare rwashyizwe kuri 0.05.Kugirango dusuzume imikorere ya Kmax, D-indangagaciro, PRC, BFSBR, EleBmax, na AdjEleBmax nkabahanuzi batera imbere kugiti cyabo, twubatsemo imikorere yimikorere yakira (ROC) kandi tubara ingingo nziza zo guca ibintu, sensitivite, umwihariko, mwiza (PPV), na Negative Predictive Agaciro (NPV).) n'akarere munsi y'umurongo (AUC) mugihe byibuze impinduka ebyiri zirenze imipaka (nkuko byasobanuwe mbere) kugirango dushyire imbere iterambere nkigenzura.
Amaso 113 y’abarwayi 76 barwaye RP yashyizwe mu bushakashatsi.Umubare munini w'abarwayi bari abagabo (n = 87, 77%) naho imyaka iri hagati yisuzuma rya mbere yari 24.09 ± 3.93.Kubijyanye na stratifike ya KC ishingiye ku kwiyongera kwa Belin / Ambrosio kwaguka kwinshi (indangagaciro ya BAD-D), ubwinshi (n = 68, 60.2%) bwamaso yari make.Abashakashatsi bahurije hamwe bahitamo kugabanya agaciro ka 7.0 kandi batandukanya keratoconus yoroheje kandi yoroheje ukurikije ibitabo26.Ariko, ibisigaye mu isesengura birimo icyitegererezo cyose.Ibiranga demokarasi, ivuriro na tomografiya biranga icyitegererezo, harimo ibisobanuro, byibuze, ntarengwa, gutandukana bisanzwe (SD) hamwe n'ibipimo hamwe 95% intera y'icyizere (IC95%), kimwe n'ibipimo bya mbere n'icya kabiri.Itandukaniro riri hagati yagaciro nyuma y amezi 12 ± 3 murashobora kubisanga mumeza 2.
Imbonerahamwe 2. Ibiranga demokarasi, ivuriro na tomografi biranga abarwayi.Ibisubizo bigaragazwa nkibisobanuro iation gutandukana bisanzwe kubihinduka bikomeza (* ibisubizo bigaragazwa nkumuhuza ± IQR), 95% intera yicyizere (95% CI), igitsina gabo nijisho ryiburyo bigaragazwa nkumubare nijanisha
Imbonerahamwe 3 irerekana umubare wamaso yashyizwe mubikorwa nkabateza imbere urebye buri kintu cyerekana tomografiya (Kmax, Km, K2, Astig, PachyMin, PRC na D-Index) ukwayo.Urebye iterambere rya KC, risobanurwa nimpinduka zagaragaye byibuze impinduka ebyiri za tomografiya, amaso 57 (50.4%) yerekanye iterambere.
Imbonerahamwe 3 Umubare ninshuro zamaso zashyizwe mubikorwa nkiterambere, ukurikije buri kintu cya tomografi ukwacyo
Kmax, D-indangagaciro, PRC, EleBmax, BFSB, na AdjEleBmax amanota nkabahanuzi bigenga berekana iterambere rya KC bigaragara mu mbonerahamwe ya 4. Urugero, niba dusobanura agaciro ntarengwa ko kongera Kmax kuri diopter 1 (D) kugirango tugaragaze iterambere, nubwo iyi parameter yerekana sensibilité ya 49%, ifite umwihariko wa 100% (imanza zose zagaragaye nkiterambere kuri iyi parameter mubyukuri byari ukuri).abaterankunga hejuru) hamwe nagaciro keza ko guhanura (PPV) ka 100%, agaciro keza ko guhanura (NPV) ka 66%, hamwe nakarere kari munsi yumurongo (AUC) ka 0.822.Nyamara, ibarwa nziza yabazwe kuri kmax yari 0.4, itanga sensibilité ya 70%, umwihariko wa 91%, PPV ya 89%, na NPV ya 75%.
Imbonerahamwe 4 Kmax, D-Index, PRC, BFSB, EleBmax, na AdjEleBmax amanota nkabahanuzi bonyine berekana iterambere rya KC (bisobanurwa nkimpinduka zikomeye mubintu bibiri cyangwa byinshi)
Ukurikije icyerekezo D, ingingo nziza yo guca ni 0.435, sensitivite ni 82%, umwihariko ni 98%, PPV ni 94%, NPV ni 84%, na AUC ni 0.927.Twemeje ko mumaso 50 yateye imbere, abarwayi 3 gusa ntibateye imbere kubindi bipimo 2 cyangwa byinshi.Mu jisho 63 aho D indangagaciro itigeze itera imbere, 10 (15.9%) yerekanye iterambere byibuze mubindi bipimo bibiri.
Kuri PRC, ingingo nziza yo guhagarika gusobanura iterambere ni igabanuka rya 0.065 hamwe na sensibilité ya 79%, umwihariko wa 80%, PPV ya 80%, NPV ya 79%, na AUC ya 0.844.
Ku bijyanye n'uburebure bw'inyuma (EleBmax), igipimo cyiza cyo kumenya iterambere cyariyongereyeho 2,5 µm hamwe na sensibilité ya 65% kandi umwihariko wa 73%.Iyo uhinduwe na BSFB ya kabiri yapimwe, ibyiyumvo byibintu bishya AdjEleBmax byari 63% naho umwihariko wazamutseho 84% hamwe nigitekerezo cyiza cya 6.5 µm.BFSB ubwayo yerekanye guca neza kwa 0,05 mm hamwe na sensibilité ya 51% kandi yihariye 80%.
Ku mutini.2 yerekana umurongo wa ROC kuri buri kintu cyagereranijwe cya tomografiya (Kmax, D-Index, PRC, EleBmax, BFSB na AdjEleBmax).Turabona ko D-indangagaciro ari ikizamini cyiza hamwe na AUC yo hejuru (0.927) ikurikirwa na PRC na Kmax.AUC EleBmax ni 0.690.Iyo uhujwe na BFSB, igenamiterere (AdjEleBmax) ryatezimbere imikorere yaryo mu kwagura AUC kuri 0.754.BFSB ubwayo ifite AUC ya 0.690.
Igishushanyo 2. Imikorere yakira umurongo (ROC) yerekana ko gukoresha indangagaciro ya D kugirango umenye iterambere rya keratoconus yageze ku rwego rwo hejuru rwo kumva no kwihariye, hagakurikiraho PRC na Kmax.AdjEleBmax iracyafatwa nkigishyize mu gaciro kandi muri rusange iruta Elebmax idafite BFSB itunganijwe.
Amagambo ahinnye: Kmax, ntarengwa ya corneal curvature;D-indangagaciro, Belin / Ambrosio D-indangagaciro;PRC, radiyo yinyuma ya curvature kuva 3.0 mm yibanze kumurongo muto;BFSB, ibereye neza inyuma;Uburebure;AdjELEBmax, impagarike ntarengwa.Ubuso bwinyuma bwa cornea bwahinduwe kuri dorsum ikwiranye.
Urebye EleBmax, BFSB, na AdjEleBmax, twemeje ko amaso 53 (46.9%), 40 (35.3%), na 45 (39.8%) yerekanaga iterambere kuri buri kintu cyihariye.Muri ayo maso, 16 (30.2%), 11 (27.5%), na 9 (45%), nta terambere ryukuri ryigeze risobanurwa byibuze nibindi bipimo bibiri.Amaso 60 adafatwa nkiterambere na EleBmax, amaso 20 (33%) yateye imbere kubindi bipimo 2 cyangwa byinshi.Amaso 28 (38.4%) na 21 (30.9%) amaso yabonwaga ko adatera imbere ukurikije BFSB na AdjEleBmax wenyine, byerekana iterambere ryukuri.
Turashaka gukora iperereza ku mikorere ya BFSB kandi, cyane cyane, BFSB yahinduwe hejuru yuburebure bwa corneal ndende (AdjEleBmax) nkibipimo bishya byo guhanura no kumenya iterambere rya KC no kubagereranya nibindi bipimo bya tomografi bikunze gukoreshwa nkibimenyetso byiterambere.Kugereranya kwakozwe hamwe n’ibipimo byavuzwe mu bitabo (nubwo bitemewe), aribyo Kmax na D-Index.20
Mugihe dushyira EleBmax kuri radiyo ya BFSB (AdjEleBmax), twabonye ubwiyongere bugaragara muburyo bwihariye - 73% kubintu bitagengwa na 84% kubintu byahinduwe - bitagize ingaruka kumyumvire (65% na 63%).Twasuzumye kandi radiyo ya BFSB ubwayo nkindi ishobora guhanura iterambere.Nyamara, sensitivite (51% vs 63%), umwihariko (80% vs 84%) na AUC (0,69 vs 0,75) yibi bipimo byari munsi yibya AdjEleBmax.
Kmax nikintu kizwi cyane cyo guhanura iterambere rya KC.27 Nta bwumvikane bushingiye ku kugabanya imipaka ikwiye.12,28 Mu bushakashatsi bwacu, twatekereje kwiyongera kwa 1D cyangwa kurenga nkigisobanuro cyiterambere.Kuri iyi mbago, twabonye ko abarwayi bose bagaragaye ko bateye imbere byemejwe byibuze nibindi bipimo bibiri, byerekana umwihariko wa 100%.Nyamara, ibyiyumvo byayo byari bike (49%), kandi iterambere ntirishobora kuboneka mumaso 29.Nyamara, mubushakashatsi bwacu, icyerekezo cyiza cya Kmax cyari 0.4 D, sensitivite yari 70%, naho umwihariko wari 91%, bivuze ko hamwe no kugabanuka ugereranije (kuva 100% kugeza 91%), twateye imbere.Ibyiyumvo biri hagati ya 49% na 70%.Ariko, ivuriro rifite akamaro kuriyi mbuga nshya rirakemangwa.Nk’uko ubushakashatsi bwakozwe na Kreps bwerekeranye no gusubiramo ibipimo bya Pentacam®, isubiramo rya Kmax ryabaye 0,61 muri kanseri yoroheje ya catarrhal na 1.66 muri colisite itagereranywa, 19 bivuze ko agaciro k’ibarurishamibare muri uru rugero kidafite akamaro gakomeye kuko gasobanura. ibintu bihamye.mugihe iterambere rishoboka rishoboka ryakoreshejwe mubindi byitegererezo.Ku rundi ruhande, Kmax, iranga impagarike ihanamye cyane ya corneal curvature yo mu karere gato 29 kandi ntishobora kubyara impinduka zigaragara muri cornea y'imbere, cornea y'inyuma, n'utundi turere twa pachymetry.30-32 Ugereranije nibintu bishya byinyuma, AdjEleBmax yerekanye sensibilité yo hejuru (63% na 49%).Amaso 20 yiterambere yamenyekanye neza akoresheje iyi parameter akabura akoresheje Kmax (ugereranije namaso 12 atera imbere yagaragaye ukoresheje Kmax aho gukoresha AdjEleBmax).Ubu bushakashatsi bushyigikira ko inyuma yinyuma ya cornea ihanamye kandi yagutse cyane hagati ugereranije nubuso bwimbere, bushobora gufasha kumenya impinduka.25,32,33
Ukurikije ubundi bushakashatsi, D-indangagaciro ni ikintu cyihariye gifite sensibilité yo hejuru (82%), umwihariko (95%) na AUC (0.927).34 Mubyukuri, ibi ntibitangaje, kubera ko iyi ari indangagaciro nyinshi.PRC yari iya kabiri ihinduka cyane (79%) ikurikiwe na AdjEleBmax (63%).Nkuko byavuzwe haruguru, uko sensibilité irenze, ibibi bike nibibi nibipimo byo gusuzuma bitera imbere.35 Kubwibyo, turasaba gukoresha AdjEleBmax (hamwe no kugabanya 7 µm kugirango utere imbere aho kuba 6.5 µm kubera ko igipimo cya digitale cyubatswe muri Pentacam® kitarimo ahantu hagaragara kuri iyi parameter) aho gukoresha EleBmax idakosowe, izaba irimo hamwe na hamwe izindi mpinduka mugusuzuma.gutera imbere kwa keratoconus kugirango tunonosore kwizerwa ryisuzuma ryamavuriro no kumenya hakiri kare iterambere.
Ariko, ubushakashatsi bwacu bufite aho bugarukira.Ubwa mbere, twakoresheje gusa ibipimo byerekana amashusho ya tomografi kugirango dusobanure kandi dusuzume iterambere, ariko ubundi buryo buraboneka kubwintego imwe, nko gusesengura ibinyabuzima, bishobora kubanziriza impinduka zose z’imiterere cyangwa imiterere.36 Icya kabiri, dukoresha igipimo kimwe cyibipimo byose byageragejwe kandi, ukurikije Ivo Guber nabandi, ugereranije hejuru yamashusho menshi bivamo urusaku rwo hasi rwo gupima.28 Mugihe ibipimo hamwe na Pentacam® byororoka neza mumaso asanzwe, byari munsi mumaso hamwe nibitagenda neza na corneal ectasia.37 Muri ubu bushakashatsi, twashyizemo gusa amaso yubatswe muri Pentacam® yo mu rwego rwo hejuru yo kwemeza scan, bivuze ko indwara zateye imbere zanze.17 Icya gatatu, turasobanura iterambere ryukuri nkufite byibuze ibipimo bibiri bishingiye kubitabo ariko bitaremezwa.Hanyuma, kandi ahari cyane cyane, guhinduka mubipimo bya Pentacam® bifite akamaro kanini mugusuzuma iterambere rya keratoconus.18,26 Murugero rwacu rwamaso 113, mugihe utondekanye ukurikije amanota BAD-D, amaso menshi (n = 68, 60.2%) yari afite uburemere, hamwe nibindi bisigaye byoroheje cyangwa byoroheje.Ariko, ukurikije urugero ruto rw'icyitegererezo, twagumanye isesengura rusange tutitaye ku buremere bwa KTC.Twakoresheje agaciro ntarengwa nibyiza kuri sample yacu yose, ariko twemera ko ibyo bishobora kongera urusaku (variable) mubipimo kandi bigatera impungenge kubyerekeranye no kubyara.Imyororokere y'ibipimo biterwa n'uburemere bwa KTC, nkuko bigaragazwa na Kreps, Gustafsson n'abandi.18.26.Kubwibyo, turasaba cyane ko ubushakashatsi buzaza bwita ku byiciro bitandukanye byindwara kandi tugasuzuma ingingo nziza zaciwe kugirango iterambere rikwiye.
Mu gusoza, kumenya hakiri kare iterambere ni ngombwa cyane kugirango dutange ubuvuzi bwihuse kugirango uhagarike iterambere (binyuze mu guhuza) 38 no gufasha kubungabunga icyerekezo nubuzima bwiza mubarwayi bacu.34 Intego nyamukuru yimirimo yacu nukwerekana ko EleBmax, ihujwe na radiyo imwe ya BFS hagati yo gupima igihe, ifite imikorere myiza kuruta EleBmax ubwayo.Iyi parameter yerekana umwihariko no gukora neza ugereranije na EleBmax, nikimwe mubintu byunvikana cyane (nuburyo bwiza bwo gusuzuma neza) bityo rero biomarker ishobora gutera imbere hakiri kare.Birasabwa cyane gukora ibipimo byinshi.Inyigisho z'ejo hazaza zirimo isesengura ryinshi ryiterambere rigomba kubamo AdjEleBmax.
Abanditsi ntibabona inkunga y'amafaranga kubushakashatsi, ubwanditsi na / cyangwa gutangaza iki kiganiro.
Margarida Ribeiro na Claudia Barbosa ni abanditsi hamwe.Abanditsi bavuga ko nta makimbirane ashimishije muri iki gikorwa.
1. Krachmer JH, Feder RS, Belin MV Keratoconus hamwe nibibazo bifitanye isano no kudatera indwara ya corneal thinning disorders.Amaso yo kurokoka.1984; 28 (4): 293–322.Minisiteri y’imbere mu gihugu: 10.1016 / 0039-6257 (84) 90094-8
2. Rabinovich Yu.S.Keratoconus.Amaso yo kurokoka.1998; 42 (4): 297–319.doi: 10.1016 / S0039-6257 (97) 00119-7
3. Tambe DS, Ivarsen A., Hjortdal J. Photorefractive keratectomy ya keratoconus.Urubanza ni amaso.2015; 6 (2): 260-2268.Ibiro byo murugo: 10.1159 / 000431306
4. Kymes SM, Walline JJ, Zadnik K, Sterling J, Gordon MO, Isuzuma rya Longitudinal Isuzuma rya Keratoconus G.Impinduka mubuzima bwiza kubarwayi barwaye keratoconus.Ndi Jay Oftalmol.2008; 145 (4): 611–617.doi: 10.1016 / j.ajo.2007.11.017
5. McMahon TT, Edrington TB, Schotka-Flynn L., Olafsson HE, Davis LJ, Shekhtman KB Longitudinal impinduka muguhindagurika kwa cornea muri keratoconus.cornea.2006; 25 (3): 296–305.doi: 10.1097 / 01.ico.0000178728.57435.df
6.]ubuvuzi bw'amaso.2019; 126 (7): 935–945.doi: 10.1016 / j.ophtha.2019.02.029
7. Andreanos KD, Hashemi K., Petrelli M., Drutsas K., Georgalas I., Kimionis GD Algorithm yo kuvura keratoconus.Kenshi Ter.2017; 6 (2): 245-22.doi: 10.1007 / s40123-017-0099-1
8. Madeira S, Vasquez A, Beato J, n'abandi.Transepithelial yihutishije guhuza corneal collagen hamwe no guhuza bisanzwe kubarwayi barwaye keratoconus: ubushakashatsi bugereranije.Ubuvuzi bw'amaso.2019; 13: 445–452.doi: 10.2147 / OPTH.S189183
9. Gomez JA, Tan D., Rapuano SJ n'abandi.Ubwumvikane bwisi yose kuri keratoconus nindwara zagutse.cornea.2015; 34 (4): 359–369.doi: 10.1097 / ICO.0000000000000408
10. Cunha AM, Sardinha T, Torrão L, Moreira R, Falcão-Reis F, Pinheiro-Costa J. Transepithelial yihutishije corneal collagen ihuza: ibisubizo byimyaka ibiri.Ubuvuzi bw'amaso.2020; 14: 2329–2337.doi: 10.2147 / OPTH.S252940
11. Wollensak G, Spoerl E, Seiler T. Riboflavin / UV iterwa na kolagen ihuza imiti yo kuvura keratoconus.Ndi Jay Oftalmol.2003; 135 (5): 620–627.doi: 10.1016 / S0002-9394 (02) 02220-1