角瘤进展的定义及其对临床实践的影响
Carina Koppen1, Marta Jiménez-García, Elke O Kreps
1Department of Ophthalmology (C.K., M.J.-G., S.N.D., J.J.R.), Antwerp University Hospital (UZA), Edegem, Belgium; Department of Medicine and Health Sciences (C.K., M.J.-G., S.N.D., J.J.R.), University of Antwerp, Antwerp, Belgium; Department of Ophthalmology (E.O.K.), Ghent University Hospital (UZA), Edegem, Belgium; and Department of Medicine and Health Sciences (E.O.K.), University of Ghent, Ghent, Belgium.
准确地定义角质的进展是避免过度治疗的关键. 结合多个诊断变量或使用更宽的边缘来显示ABCD进展,可以提高一致性,并将进展率与临床观察保持一致.
科学领域:
- 眼科医生 眼科 眼科
- 角膜疾病 角膜疾病
- 视觉科学 视觉科学 视觉科学
背景情况:
- 角 (KC) 进展标准缺乏共识,导致潜在的过度治疗.
- 建立可靠的方法来识别渐进的KC对于适当的患者管理至关重要.
研究的目的:
- 为了评估各种角质进展标准的表现.
- 将这些标准与已建立的关于KC演变的临床知识进行比较.
主要方法:
- 追溯分析906名角患者的数据.
- 根据角质测量 (K MAX),额头纹 (A F),心态测量 (P MIN) 和ABCD进展显示的评估进展标准.
- 评估了个体和人群的进展检测的一致性.
主要成果:
- 单一的进展标准产生了被标记为渐进的眼睛的高率 (R PROG).
- 结合K MAX和P MIN显示出比K MAX和A F.更好的种群一致性.
- 替代标准 (K2F和R mB) 显示出更高的一致性和更低的可变性.
- 调整ABCD显示以更宽的置信区间将R PROG降低到27.9%.
结论:
- 目前的进展标准可能会导致过度治疗,因为R PROG值很高.
- 在进展显示中结合变量或扩大边缘可以提高一致性.
- 修订后的标准使R PROG更接近观察到的临床进展率 (20-30%).
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