图形视诱发电位对甲状腺相关眼病视神经病变的诊断价值  

P-VEP in the evaluation of dysthyroid optic neuropathy

作　　者：王莉菲[1] 吴中耀[1] 黄时洲[1] 杨华胜[1] 陈景荣[1] 陈智聪[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2005年第4期377-380,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的　评价图形视诱发电位(P -VEP)在甲状腺相关眼病视神经病变(DON)中的诊断价值及其影响因素。方法　对2 0 0 2年1月至2 0 0 3年12月收治的99例(188眼)TAO患者行常规P -VEP检查,比较矫正视力≥1. 0患眼与正常值之间以及矫正视力≥1 .0与<1. 0TAO患者之间P10. 0潜伏期及振幅变化;观察眶压、眼压及眼球突出对P10 .0潜伏期的影响;比较P -VEP与视野检查在DON中的诊断价值。结果　矫正视力≥1. 0组P10 .0平均潜伏期及振幅较正常值均有明显差异;视力≥1 .0组与<1 .0组比较,后者P10. 0潜伏期在中、高空间频率明显较前者延迟;眶压对P10. 0潜伏期影响最大;P -VEP较视野检查更灵敏,两者联合阳性率可达93 97%。结论　P -VEP视功能检查可以更敏感的较早发现DON的发生,并且可在一定程度上判断视神经的损伤程度;眶压在DON发生、发展中起关键性作用;P -VEP与视野检查联合应用可明显提高DON的诊断阳性率。Objective To evaluate the function of the pattern visual evoked potential(P-VEP)in the diagnosis of dysthyroid optic neuropathy.Methods Ninety nine TAO patients(188 eyes)were collected from 2002 to 2003.P-VEP and other clinical manifestations were analyzed.P-VEP P-100 latencies and amplitudes were compared between patients and normal.The influence of orbital pressure?ocular pressure and proptosis on P-100 latencies were observed.Compared the function between P-VEP and visual field in diagnosis of DON.Results P-VEP P-100 latency values were significantly different either between the TAO patients with corrected vision ≥1.0 and normal values or TAO patients with between vision ≥1.0 and vision <1.0.Orbit pressure has an important effect on P-100 latencies.P-VEP is more sensitive than visual field,otherwise combination P-VEP with visual field can increase diagnostic positive rate up to 93.97%.Conclusions Clinical application of P-VEP can find the optic nerve involvement of TAO patients early,and it may evaluate the degree of visual function damage.The combination of P-VEP and visual field may be a more useful index.

关 键 词：甲状腺相关眼病 图形视诱发电位 视神经病变 诊断价值 P100潜伏期 P-VEP 2002年1月 矫正视力 视野检查 2003年 DON 视功能检查 振幅变化 眼球突出 空间频率 损伤程度 正常值 阳性率 眶压 早发现 关键性 患者 灵敏 

分 类 号：R771.3[医药卫生—眼科] R779.12[医药卫生—临床医学]