视觉诱发电位和多焦点视网膜电图在眼钝挫伤功能评估中的作用  

Visual evoked potential and multifocal electroretinogram in diagnosis of ocular contusion

作　　者：齐林嵩 姚璐[1] 安晶[1] 张磊[1] 张作明[1,2] 

机构地区：[1]第四军医大学:航空航天医学系航空航天临床医学教研室、教育部航空航天医学重点实验室,西安710032 [2]第四军医大学西京医院眼科、全军眼科研究所,西安710032

出　　处：《第三军医大学学报》2015年第10期1030-1034,共5页Journal of Third Military Medical University

摘　　要：目的探讨视觉诱发电位(visual evoked potential,VEP)和多焦点视网膜电图(multifocal electroretinogram,mf ERG)两种检测项目联合分析在评估眼钝挫伤视觉功能中的价值。方法对2012年11月至2013年7月期间来我院就诊的44例单侧眼挫伤患者进行视网膜电图(ERG)、视觉诱发电位(VEP)、多焦点视网膜电图(mf ERG)检查,并与自身健侧眼为对照眼比较。同时分析图形VEP(P-VEP)和mf ERG在诊断眼钝挫伤上的一致性,以及与受伤天数和视力的相关性。结果与健侧眼比较视觉电生理各指标,结果显示损伤眼表现为P-VEP P100的峰时值显著延长和幅值显著降低(P<0.05),F-VEP P1的幅值显著降低(P<0.05)和mf ERG的中心反应幅值显著降低(P<0.05)。P-VEP和mf ERG两种方法对44例患者的诊断阳性率差异不显著,但是两种诊断结果的一致性极低,说明两种检查方法可以从两个方面对眼球钝挫伤进行诊断。受伤天数与P-VEP潜伏期和幅值、mf ERG中心反应没有明显相关性。视力与P100峰时值具有相关性。结论眼外伤导致视神经受损的同时也可能伴有黄斑功能的下降,并且VEP和mf ERG两种方法联合应用对眼外伤早期诊断,提高阳性率及后续的治疗工作具有重要意义。Objective To investigate the value of visual evoked potential （VEP） Combined with muhifocal electroretinogram （rnfERG） in the diagnosis of ocular contusion. Methods VEP, electroretinogram （ERG） and mfERG were detected in 44 patients with unilateral optic nerve contusion, and the results were compared with those of contralateral healthy eyes. In addition, VEP and mfERG consistency in diagnosis of eye contusion was analyzed, and the correlation of the VEP, mfERG, injury duration and visual acuity was further analyzed. Results There were significant differences in the amplitude and the latency of pattern VEP （P-VEP） P]0o （ P 〈 0.05 ）, and in the amplitude of mfERG （ P 〈 0.05 ） and the amplitude of flash VEP （F-VEP） P1 （P 〈 0.05 ） between the damaged eyes and the contralateral healthy eyes, but there was no significant difference in ERGs. The injured duration had no correlation with the amplitude and the latency of P-VEP P100 and mfERG, but the visual acuity was significantly relevant with the amplitude and the latency of P-VEP P100 and the amplitude of mfERG. Conclusion Ocular trauma can lead to optic nerve damage and also may be associated with decreased macular function. The combination analysis of VEP and mfERG is beneficial to early diagnosis of ocular trauma, and can improve the positive rate in clinic practice.

关 键 词：眼外伤 眼钝挫伤 视神经钝挫伤 视觉诱发电位 多焦点视网膜电图 

分 类 号：R770.43[医药卫生—眼科] R779.12[医药卫生—临床医学]