视觉诱发电位定义视觉发育关键期对弱视治疗的临床应用探讨  

Using visual evoked potential to assess critical period of visual development in clinical application of amblyopia treatment

作　　者：丁素真 刘丹 董洁[1] 朱贺飞[1] 彭丹 李少敏 李兰[1] Ding Su-zhen;Liu Dan;Dong Jie(Kunming First People's Hospital Ophthalmology Department,Kunming 650051,China)

机构地区：[1]昆明市第一人民医院眼科,650051 [2]美国哈佛大学布莱根与妇女医院

出　　处：《中国斜视与小儿眼科杂志》2021年第3期24-24,I0001-I0004,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：云南省科技计划项目(2016IA022);国家自然科学基金地区科学(81860180)。

摘　　要：目的通过对比视觉发育关键期前后正常小鼠和正常人VEP的改变,探讨VEP评估视皮层突触可塑性在弱视治疗上的临床应用。方法对比正常3周龄小鼠和2月龄小鼠VEP的差异,对比正常儿童(3~10岁)和成人(18~30岁)VEP的差异,分析VEP在正常小鼠和人视觉发育关键期前后的改变;依据VEP典型指标(P100波振幅),将弱视眼分为两组,对比相同治疗后两组弱视眼BCVA变化情况,分析治疗前VEP与弱视眼BCVA变化值的相关性。结果正常成年鼠较幼年鼠N1、P2波潜伏期均缩短、N1-P2波振幅降低,差异有统计学意义;正常成人较儿童N75、P100潜伏期变化差异无统计学意义;N75-P100波振幅下降,差异有统计学意义;采用相同的方法治疗6月,治疗前P100波振幅正常和P100波振幅低于正常的弱视眼BCVA均改善,差异有统计学意义,且弱视眼BCVA变化值与治疗前P100波振幅存在显著正相关性。结论正常小鼠和人视觉发育关键期过后VEP最显著的变化均是P波振幅下降;治疗前P100波振幅与弱视眼BCVA变化值具有正相关性。因此,视觉诱发电位可作为临床评估视皮层突触可塑性,预测弱视眼治疗效果的指标。Objective Comparing changes of VEP in normal mice and normal people before and after the critical period of visual development,the aim is to discuss that VEP evaluates synaptic plasticity of visual cortex in amblyopia clinical application.Methods The differences of VEP between normal mice aged 3 weeks and 2 months were compared,and the differences of VEP between normal children(3~10 years)and adults(18~30 years)were compared.Then the conclusion of VEP changes before and after the critical period of visual development in normal mice and human were made.According to the typical indicator of VEP(P100 wave amplitude),the amblyopic eyes were divided into two groups.After same treatment,BCVA changes of amblyopic eyes of the two groups were compared,and the correlation between VEP and BCVA changes of amblyopic eyes was analyzed.Results Compared with juvenile mice,the latency of N1 and P2 waves were shorter,the amplitude of N1-P2 waves was lower in normal adult mice,difference was statistically significant.There was no significant difference of N75 and P100 latency between normal adults and children;while N75-P100 wave amplitude decreased,and the difference was statistically significant.After same treatment for 6 months,BCVA of amblyopic eyes with normal P100 wave amplitude and lower P100 wave amplitude were both improved(difference was statistically significant).Meanwhile,the change of BCVA in amblyopic eyes had a significant positive correlation with P100 wave amplitude.Conclusions After the critical period of visual development in normal mice and human,the most significant change of VEP is the decrease of P-wave amplitude.The amplitude of P100 wave is positively correlated with the change of BCVA in amblyopic eyes.Therefore,VEP can be used as an indicator to evaluate the synaptic plasticity of visual cortex and predict the therapeutic effect of amblyopic eyes.

关 键 词：视觉诱发电位 视觉发育关键期 弱视 治疗 

分 类 号：R777.44[医药卫生—眼科]