摘要
目的:观察前部缺血性视神经病变(AION)中视野和图形视觉诱发电位(p-vep)的变化及相关性分析。方法:选取AION患者112例为观察组,其中患眼138只、对侧健眼86只;另选取同期健康体检者95例(95只眼)为对照组。所有对象均行视野、p-vep检查,比较观察组患眼、对侧眼及对照组视野指数[平均敏感度(MS)、平均缺损(MD)、丢失方差(LV)、模式标准偏差(PSD)]、p-vep的P100振幅与潜伏期,分析视野、p-vep单一及联合对AION的诊断价值,并比较观察组治疗前后视野指数、p-vep指标的变化,分析治疗后二者相关性。结果:(1)观察组患眼视野MS低于观察组对侧健眼、对照组,MD、LV、PSD高于观察组对侧健眼、对照组(P<0.05);(2)观察组患眼p-vep的P100波潜伏期高于观察组对侧健眼、对照组,p-vep的P100波振幅低于观察组对侧健眼、对照组(P<0.05);(3)P100波振幅、MD联合诊断AION的曲线下面积(AUC)(0.861)>P100波振幅(0.818)>PSD(0.813)>MD(0.761)>LV(0.753)>P100波潜伏期(0.739)>MS(0.731),截断值敏感度为70.65%,特异性为90.53%;(4)治疗后,观察组视野MS高于治疗前,视野MD、LV、PSD低于治疗前(P<0.05);(5)治疗后,观察组p-vep的P100波潜伏期低于治疗前,p-vep的P100波振幅高于治疗前(P<0.05);(6)治疗后,P100波潜伏期与MD、LV、PSD呈正相关,与MS呈负相关;P100波振幅与MD、LV、PSD呈负相关,与MS呈正相关(P<0.05)。结论:AION患者经有效治疗后视野缺损、p-vep的P100波潜伏期及振幅得到显著改善,联合视野与p-vep检查可相互验证、相互补充,有助于指导临床诊断、治疗及预后。
Objective:To observe the changes of anterior ischemic optic neuropathy(AION)before and after treatment of visual field and pattern visual evoked potentials(p-vep)and its correlation with efficacy.Methods:A total of 112 AION patients were selected as the observation group,including 138 eyes and 86 contralecional healthy eyes,and 95 healthy patients(95 eyes)during the same period were selected as the control group.VEP and visual field were examined in all objects,the eye,the contralateral eye in observation group and the vision control index[mean sensitivity(MS),mean defect(MD),lost variance(LV),pattern standard deviation(PSD)]of the control group,p-vep and incubation period,amplitude of P100 analysis view were compared.To analyze the diagnostic value of visual field,p-vep single and combined in AION,and compare the changes of visual field index and p-vep index in the observation group before and after treatment,and analyze the correlation between the two after treatment.Results:(1)The visual field MS of the eye in the observation group was lower than that of the contralateral healthy eye in the observation group and control group,and the MD,LV and PSD were higher than the contralateral healthy eye in the observation group and control group(P<0.05).(2)The amplitude of P100 wave of p-vep in the observation group was higher than that of the contralateral healthy eye in the observation group and control group,the amplitude of P100 wave of p-vep was lower than the contralateral healthy eye of the observation group and control group(P<0.05).(3)P100 wave amplitude,MD area under the combined diagnosis of AION(AUC)(0.861)>P100 wave amplitude(0.818)>PSD(0.813)>MD(0.761)>LV(0.753)>P100 wave latency(0.739)>MS(0.731),the cutoff value had a sensitivity of 70.65%,and the specificity was 90.53%.(4)The visual field MS after treatment in the observation group was higher than that before treatment,and the visual field MD,LV,and PSD were lower than before treatment(P<0.05).(5)The p-vep P100 wave latency of the observation group after treatment was lower than before treatment,and the p-vep P100 wave amplitude was higher than before treatment(P<0.05).(6)After treatment,the P100 wave latency was positively correlated with MD,LV,PSD,and negatively correlated with MS,P100 wave amplitude was negatively correlated with MD,LV,and PSD,and positively correlated with MS(P<0.05).Conclusion:After effective treatment of AION patients,visual field defects,p-vep P100 wave latency and amplitude have been significantly improved,combined visual field and p-vep examination can verify and complement each other,and help guide clinical diagnosis,treatment and prognosis.
作者
郭金喜
赵云
路璐
GUO Jin-xi;ZHAO Yun;LU Lu(Department of Clinical Laboratory Special Inspection Section,Hebei Eye Hospital,Xingtai 054001,Hebei,China)
出处
《川北医学院学报》
CAS
2020年第4期655-659,共5页
Journal of North Sichuan Medical College
基金
河北省邢台市科技支撑计划项目(2016ZC078)。
关键词
前部缺血性视神经病变
视野检查
图形视觉诱发电位
视野缺损
光敏感度
Anterior ischemic optic neuropathy
Visual field examination
Pattern visual evoked potential
Visual field defect
Light sensitivity
