Beneficios del sistema Scheimpflug en glaucoma

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Abstract

Entre los medios diagnósticos que más se han difundido en los últimos años se encuentran los basados en las imágenes de Scheimpflug, como el Pentacam de Oculus Wetzlar de Alemania. Entre sus modelos de evaluación contiene la realización de la paquimetría central y curvatura corneal, así como fórmulas de corrección de la presión intraocular. Permite la medición de la amplitud angular y de la profundidad y volumen de la cámara anterior. Las publicaciones validan la alta reproducibilidad de sus mensuraciones por lo que se ha hecho útil en la evaluación del glaucoma.

Translated abstract

Scheimpflug´s images as is the case of Oculus Wetzlar´s Pentacam from Germany, are one of the most widely known diagnostic techniques for the evaluation of the anterior segment of the eye. Its evaluating models comprise the central pachymetry and the corneal curvature as well as the correction formulas for the intraocular pressure. It allows the anterior chamber amplitude, volume and depth measurements with high reproducibility, being useful in the evaluation of glaucoma.

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Most cited references 29

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Repeatability and reproducibility of central corneal thickness measurement with Pentacam, Orbscan, and ultrasound.

Gerald Schmidinger, S Pieh, C Skorpik … (2005)

The purpose of this study was to compare central corneal thickness (CCT) measurements obtained with a novel rotating Scheimpflug camera (Pentacam; Oculus) with scanning slit topography (Orbscan; Bausch & Lomb), and with ultrasound pachymetry (SP-2000; Tomey). CCT in 30 healthy eyes was measured twice with each modality by 2 independent observers in random order. The results from scanning slit topography are given both with and without multiplication with the "acoustic correction factor" of 0.92. In addition, the displayed images from the rotating Scheimpflug camera and scanning slit topography were used to calculate the signal difference-to-noise ratios (SD/N) between cornea and background signal. The mean CCT values as determined with the different modalities (+/-standard deviation) were: 542+/-29 microm, 576+/-37 microm, 530+/-34 microm, and 552+/-32 microm for rotating Scheimpflug imaging, for uncorrected and for corrected scanning slit pachymetry, and for ultrasound, respectively. The differences between modalities (+/-95% limits of agreement) were -9.8+/-31 microm between rotating Scheimpflug and ultrasound, 24+/-31.2 microm between scanning slit and ultrasound, and 33+/-27 microm between scanning slit and rotating Scheimpflug imaging. The limits of agreement for within and between observer effects were within 4.2% of the absolute CCT values for scanning slit and ultrasound and within 2.2% for the rotating Scheimpflug imaging. The rotating Scheimpflug camera showed similar SD/N ratios but steeper edges of the corneal surfaces in the intensity profile plots. In the assessment of normal corneas, the Pentacam measured CCT values closer to ultrasound pachymetry and with less variability compared with Orbscan. The (interobserver) reproducibility with the Pentacam was highest of all 3 modalities.

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Anterior chamber measurements using Pentacam rotating Scheimpflug camera.

Ramin Khoramnia, T Rabsilber, Gerd Auffarth (2006)

To investigate the mean values and standard deviations according to age, reliability, and correlation between different parameters of anterior chamber measurements using the Pentacam rotating Scheimpflug camera. Heidelberg IOL and Refractive Surgery Research Group, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. This prospective clinical study comprised 76 healthy volunteers (mean age 46.6 years +/- 16.8 [SD]). Three consecutive measurements were made of only 1 eye and anterior chamber depth (ACD), mean and minimum anterior chamber angle (ACA), and anterior chamber volume (ACV) were evaluated. Mean ACD was 2.93 +/- 0.36 mm, mean ACA was 34.81 +/- 5.05 degrees, minimum ACA was 29.99 +/- 5.53 degrees, and mean ACV was 160.3 +/- 36.81 mm3. Increasing age was associated with reduced ACD and ACV; however, mean and minimum ACAs were lowest in patients aged 40 to 59 years. Excellent correlation was found between ACD and ACV (R = 0.92). Anterior chamber depth and mean ACA correlated only moderately (R = 0.65). The correlation coefficient between ACD and minimum ACA was smaller (R = 0.58). There was no correlation between ACV and ACA (R = 0.37). Minor standard deviations were noted (ACD 0.02 +/- 0.02 mm, mean ACA 1.12 +/- 0.94 degrees, minimum ACA 2.04 +/- 2.67 degrees, and ACV 2.48 +/- 1.65 mm3). Using the Pentacam, it was possible to examine different parameters of the anterior chamber within a short period and with good reliability. The evaluation of the ACA in different positions can help to classify the potential risk for angle-closure glaucoma.

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Comparison of Pentacam and Orbscan IIz on posterior curvature topography measurements in keratoconus eyes.

Susannah V Quisling, Stacy A Sjoberg, Bridget Zimmerman … (2006)

To compare the measurements of posterior elevation above the best-fit sphere and of pachymetry in established keratoconus patients using 2 different technologies--Scheimpflug imaging with the Pentacam and scanning slit combined with Placido imaging with Orbscan IIz. Retrospective comparative case series. Patients with confirmed keratoconus by biomicroscopy and Placido topography who had corneal topography scans by the Pentacam and Orbscan IIz on their visit from April 2004 to April 2005. These scans were obtained routinely for patient diagnosis, treatment, and progression. The mean difference, standard deviation (SD), and 95% limits of agreement (LOA) were calculated, and Bland-Altman plots were constructed for best-fit sphere radius of curvature, posterior elevation above the best-fit sphere, and pachymetry of the thinnest point. Thirty-six eyes of 29 patients were analyzed. The average radius for posterior best-fit sphere was 5.97 microm (range, 4.69-6.79) for the Pentacam and 6.00 microm (range, 4.97-6.55) for Orbscan IIz. The mean difference (Pentacam - Orbscan IIz) for the radius generated for the best-fit sphere was -0.03+/-0.22 SD with a 95% confidence interval (CI) of -0.11 to 0.04 and a 95% LOA of -0.46 to 0.40 (P = 0.362). The mean posterior elevation by best-fit sphere fixed to the apex was 34.86 microm (range, 3-120) for the Pentacam and 48.50 microm (range, 11-118) for Orbscan IIz. The mean difference was -13.64+/-26.08 SD (95% CI, -22.46 to -4.81; 95% LOA, -64.75 to 37.48; P = 0.003). The average thinnest point for the Pentacam was 443.6 microm (range, 164-587), and that for Orbscan IIz was 445.9 microm (range, 204-597). The mean difference in the thinnest point for the Pentacam and Orbscan IIz was -2.28+/-35.55 (95% CI, -14.31 to 9.75; 95% LOA, -71.95 to 67.39; P = 0.703). Both the Pentacam and Orbscan IIz determine similar thinnest points but have a measurable difference in posterior elevations above the best-fit sphere, despite similar radii of curvature. This difference may be important in the screening of patients for refractive surgery to avoid surgery on patients with early keratoconus. This study cannot determine if the Pentacam is underestimating the posterior vault or if Orbscan is overestimating this height, and further studies with a standardized test object are needed.

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Author and article information

Contributors

Marerneda Domínguez Randulfe: Role: ND

Liamet Fernández Argones: Role: ND

Maritza Miqueli Rodríguez: Role: ND

Ibraín Piloto Díaz: Role: ND

Francisco Yunier Fumero González: Role: ND

María Teresa Ferrer Guerra: Role: ND

Journal

Journal ID (publisher): oft

Title: Revista Cubana de Oftalmología

Abbreviated Title: Rev Cubana Oftalmol

Publisher: Editorial Ciencias Médicas (Ciudad de la Habana )

ISSN: 1561-3070

Publication date (Print): 2012

Volume: 25

Issue: suppl 1

Pages: 449-457

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[1 ] Instituto Cubano de Oftalmología Ramón Pando Ferrer Cuba

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Publisher ID: S0864-21762012000300011

SO-VID: 00cf5296-3dea-49ff-a5a6-1a3457f225ae

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http://creativecommons.org/licenses/by/4.0/

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Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0864-2176&lng=en

Beneficios del sistema Scheimpflug en glaucoma Translated title: Benefits of Scheimpflug system for the treatment of glaucoma

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Most cited references 29

Repeatability and reproducibility of central corneal thickness measurement with Pentacam, Orbscan, and ultrasound.

Anterior chamber measurements using Pentacam rotating Scheimpflug camera.

Comparison of Pentacam and Orbscan IIz on posterior curvature topography measurements in keratoconus eyes.

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