摘要
目的:记录正常人和青光眼患者的多焦视觉诱发电位(multifocalvisualevokedpotential,mfVEP),评价mfVEP在青光眼诊断及病情监测中的价值。方法:采用法国VisionMonitor多焦视觉电生理仪的二阶kernel技术检测21例32只正常对照眼、37例58只原发性青光眼的mfVEP,比较同一个体双眼间的振幅均方根(rootmeansquare,RMS),并分析原发性青光眼患者的mfVEP与Humphrey视野(Humphreyvisualfield,HVF)的相关性。结果:正常人RMS值与年龄、眼别无关,但女性RMS值大于男性,差异有显著性意义(P<0.05);正常眼mfVEP的RMS值个体间变异大(变异系数CV=43.05%),但同一个体双眼间反应差异不大;双眼损害程度相近的青光眼,双眼mfVEP的RMS值无明显差异(P=0.251);双眼损害程度不一的青光眼,双眼RMS值不同(P=0.024);mfVEP的RMS值总和与视野的平均缺损值(meandefect,MD)具有较强的相关性(rs=-0.487,P=0.000)。结论:正常人mfVEP个体间变异性大,但同一个体双眼间反应差异不大。对于青光眼双眼损害程度不一或单眼损害者,进行双眼间mfVEP非对称分析,可以早期发现青光眼损害并进行病情监测。青光眼患者的mfVEP振幅与视野平均缺损值相关性较好,在一定程度上可以弥补主观视野检查的不足。
AIM： To study the characteristic of the normal multifo- cal visual evoked potential （mfVEP） and to test the ability of mfVEP in detecting glaucoma using the mfVEP from normal is subjects, glaucomatous patients.
METHODS： mfVEPs of 32 normal eyes （n=21） and 58 eyes （n=37） with primary glaucoma were recorded with the Vision Monitor electrophysical apparatus by the second kernel analysis. Humphrey automated visual fields （HVF） were also obtained from the eyes with glaucoma to determine the correlation between them. RESULTS： 1.The study showed that signals in the center zone of the normal had the largest amplitudes （194.32 ± 126.21nV/deg^2）. There was little effect of age on the amplitudes and latent time and no difference was found between the two eyes, while the amplitudes of female （19.41± 5.27 nV/deg^2） were larger than that of the male （10.12± 2.83 nV/deg^2） （P〈0.05）;2. There was significant interindMdual variability （the coefficient of variation was 43.05%） in mfVEP amplitudes in the normal subjects but the variability within two eyes of the same individual was small;3. The amplitudes of eyes with glaucoma were smaller than that of the normal eyes and significantly statistJcal difference were found in the 0-10°ring zone （P〈0. 05） while no difference of the latent time was observed between them; 4. If the two eyes of one patient with glaucoma were damaged to the same extent, the amplitudes of the two eyes were almost the same; while not to the same extent the amplitudes were different. 5.The summation values of mfVEP amplitudes and HVF mean deviation values was strongly correlated （rs = -0.487,P=0.000）.The established glaucoma eyes with field defect were also confirmed in the mfVEP and the correlation of the topographic location was good.
CONCLUSION： The large individual variability of mfVEP responses limits the detecting of the early field defect by the simple signal comparison between the normal subjects and the patients with glaucoma. By using intereye asymmetry analysis the early visual field defect may be detected as for the damages within the two eyes are not the same or only one eye is damaged. The measurement is not applicable to both eyes damaged to the same extent. For the established glaucomatous eyes, the amplitudes of the mfVEP descend and has a strong correlation with the ID value, which to some extent may offset the shortage of the automated visual field.
出处
《国际眼科杂志》
CAS
2006年第1期110-113,共4页
International Eye Science
关键词
多焦视觉诱发电位
原发性青光眼
视野
multifocal visual evoked potential
primary glaucoma
Humphrey visual field
