图形视觉诱发电位鉴别伪盲的临床应用研究

发布时间：2018-04-13 17:36

本文选题：图形视觉诱发电位 + 客观视力　；参考：《眼科新进展》2016年12期

【摘要】：目的用图形视觉诱发电位(pattern visual evoked potential,P-VEP)来评价客观视力以及用来鉴别伪盲的临床应用价值。方法取志愿受检者158例(158眼)患黄斑病变或视神经病变眼,其中65眼为黄斑病变组(A组),93眼为视神经病变组(B组),通过多元回归分析P-VEP波幅和潜伏期与最佳矫正视力的关系。由此得出最佳关系方程,进而得出158眼P-VEP推算视力(PVEPVA),以及53只伪盲眼(包括21眼黄斑病变及32眼视神经病变)的PVEP-VA,最后用受试者工作特征曲线(ROC曲线)得出可接受PVEP-VA及主观视力差值范围,从而鉴别伪盲。结果在15'视角黑白棋盘格刺激下引出的P-VEP波形,该波形的P100波幅(记录为Amp15')与主观视力的相关性最好,Amp15'与主观视力显著相关(A组:P=0.016;B组:P0.0001)。Amp15'的对数[log(Amp15')]与主观视力(log MAR)的回归方程为:A组:y=1.867-1.100x,P0.000 1,B组:y=1.502-0.799x,P0.000 1[x为log(Amp15'),y为log MAR]。利用回归曲线和ROC曲线可以得到A组辨别伪盲的截断值为0.397 2时,其诊断敏感性为73.3%,特异性为68.0%;B组辨别伪盲的截断值为0.415 0,其诊断敏感性为90.5%,特异性为67.5%。结论 PVEP的Amp15'用来判断客观视力最有效,对于鉴别伪盲也很有意义。
[Abstract]:Objective to evaluate the objective visual acuity and the clinical application value of pattern visual evoked potentialP-VEP.Methods one hundred and fifty-eight patients (158 eyes) with macular lesion or optic neuropathy were enrolled. Among them, 65 eyes were macular lesion group (group A) and 93 eyes were optic neuropathy group (group B). The relationship between the amplitude and latency of P-VEP wave and the best corrected visual acuity was analyzed by multiple regression analysis.The best relation equation can be obtained.In order to distinguish pseudo-blindness.Results the P-VEP waveform induced by the stimulation of 15'view black and white checkerboard,By using regression curve and ROC curve, the truncation value of group A is 0.397, the diagnostic sensitivity is 73.3and the specificity is 68.0. The truncation value of group B is 0.415, the diagnostic sensitivity is 90.5 and the specificity is 67.5.Conclusion Amp15'of PVEP is the most effective method to judge objective visual acuity, and it is also useful to distinguish false blindness.
【作者单位】：华中科技大学同济医学院附属武汉市中心医院眼科;
【基金】：国家青年科学基金资助项目(编号:81300761)~~
【分类号】：R774

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