柯谛亚电生理仪在外伤性视神经病变诊断中的应用研究  

The application of cotia visual electrophysiological system in the diagnosis of traumatic optic neuropathy

作　　者：张立宇 许育新[1] 方俊杰[2] 肖圣兵[2] ZHANG Li-yu;XU Yu-xin;FANG Jun-jie(The 2nd Affiliated Hospital of Anhui Medical University,Hefei 230601,Anhui;Department of Public Security Physical evidence Center of Anhui Province,Hefei 230061,Anhui)

机构地区：[1]安徽医科大学第二附属医院眼科,安徽合肥230601 [2]安徽省公安厅物证鉴定处,安徽合肥230061

出　　处：《安徽医专学报》2022年第3期92-94,共3页Journal of Anhui Medical College

基　　金：安徽省科技厅重点研究与开发项目(编号:201904d07020003)。

摘　　要：目的:探讨柯谛亚视觉电生理仪在检测外伤性视神经病变诊断中的应用价值。方法:选取就诊于某医院眼科的外伤性视神经病变确诊患者44例50眼,正常对照组25例50眼,所有纳入人员均进行裸眼视力、矫正视力、OCT、P-VEP、IC-VEP、视野及眼底检查等,对VEP结果数据进行统计分析。结果:对TON患者行P-VEP及IC-VEP定性检测,两者联合检测出结果异常的比例为96%,传统P-VEP检测结果异常占比86%。在P-VEP及IC-VEP定量(8%、16%、32%、64%)模式检测下:TON组与正常组无论是在P-VEP还是IC-VEP检测中,各组间的潜伏期、振幅及SNR值差异均具有统计学意义(P<0.01);TON轻度组与正常组比较,8%模式SNR值差异具有统计学意义(P<0.01)。TON患者各组间比较,轻度组与中度组P-VEP检测的幅值结果以及中度组与重度组间所有检测结果差异无统计学意义(P>0.05),余各组间差异具有统计学意义(P<0.01)。结论:IC-VEP联合P-VEP检测相比于传统P-VEP检测更全面,可以弥补部分TON患者视网膜神经节M细胞通道损伤的检测,更大程度的减少漏诊。柯谛亚视觉电生理仪的IC-VEP定量模式可以评估视力损伤程度,为外伤性视神经损伤诊断提供了新的技术手段。Objective:To analyze the value of Cotia visual electrophysiological system in the diagnosis of traumatic optic neuropathy.Methods:A total of 50 eyes of 44 confirmed traumatic optic neuropathy cases were selected from the patients treated in hospital,and 50 eyes of 25 normal subjects were selected as control group.All subjects received OCT,P-VEP,IC-VEP and visual field test,and measurement VEP results were analyzed.Results:Among 50 eyes of 44 confirmed cases who underwent P-VEP and IC-VEP qualitative tests,the proportion of abnormal results detected by the combination of P-VEP and IC-VEP was 96%,while the traditional P-VEP was 86%;the incubation period,amplitude and SNR values both of TON group and control group which results showing a statistical meaning in P-VEP and IC-VEP quantitative mode(8%,16%,32%,64%)(P<0.01);The SNR value of 8%mode was significantly different between the control group and mild group(P<0.01);There were no significant differences in P-VEP amplitude between the mild group and the moderate group,and all results between the moderate group and the severe group(P>0.05),while there were significant differences among the other groups(P<0.01).Conclusion:IC-VEP combined with P-VEP test is more comprehensive compared with traditional P-VEP test.IC-VEP combined with P-VEP test can make up for the detection damage of Magnocellular pathway in some TON patients,and immensely reduce misdiagnosis.The IC-VEP quantitative mode of Cotia visual electrophysiological system also can evaluate the degree of visual injury,and provide a new technique for the diagnosis of traumatic optic neuropathy.

关 键 词：分离格栅视觉诱发电位 图形视觉诱发电位 信噪比 定量模式 外伤性视神经病变 

分 类 号：R745[医药卫生—神经病学与精神病学]