分离格栅模式视觉诱发电位对开角型青光眼早期诊断的临床观察

目的 探讨分离格栅模式视觉诱发电位( ic-VEP)定性模式检查在开角型青光眼早期诊断中的应用价值,为临床青光眼早期诊断提供客观敏感而有效依据.方法 随机选择原发性开角型青光眼患者68例(82眼)和正常对照者47例(76眼),分别进行ic-VEP与视野、视网膜神经纤维层厚度(RNFLT)进行多元相关分析,分析ic-VEP在开角型青光眼诊断中的敏感度及特异度.结果 青光眼组和正常对照组年龄、屈光度和中央角膜厚度差异均无统计学意义,而青光眼组患者的眼压、视野、RNFLT和ic-VEP与正常组相比差异具有统计学意义(P＜0.01).在青光眼组患者中,ic-VEP信号噪音比(SNR)与屈光度、眼压、视野和RNFLT的相关性分析表明,ic-VEP SNR与眼压、视野和RNFLT损伤显著相关(P＜0.01). ic-VEP检测开角型青光眼的敏感度为90. 2% ,特异度为88. 2% . ic-VEP与视野检查及 RNFLT损伤的一致性较好.结论 ic-VEP对原发性开角型青光眼的诊断具有较高的敏感度和特异度,视野、RNFLT 的损伤和 ic-VEP SNR相关.

Clinical observation of early detection of open angle glaucoma by the application of isolated-check visual evoked potential

Objective To explore the value of qualitative pattern of isolated-check visual evoked potential ( ic-VEP) in the early diagnosis of primary open-angle glaucoma ( POAG) , and to provide an objective and effective basis for the early diagnosis of clinical glaucoma. Methods Sixty-eight patients (82 eyes) with normal POAG were randomly selected. Forty-seven normal individuals (76 eyes) were as control group. Both groups were treated to analyze ic-VEP,the defect of the visual field, the thickness of the retinal nerve fiber layer ( RNFLT) , and the mult-ivariate correlation analysis between ic-VEP, the visual field and RNFLT was performed. The sensitivity and speci-ficity of ic-VEP in the diagnosis of POAG was analysis in this study. Results There were no significant differences in age, diopter and central corneal thickness between glaucoma group and normal control group. However, the in-traocular pressure ( IOP) , the visual field, RNFLT and ic-VEP between two groups were statistically different( P＜0.01) . The correlation analysis of ic-VEP Signal-to-noise ratio ( SNR) with diopter, IOP, the visual field and RN-FLT in the glaucoma group showed that ic-VEP SNR was significantly associated with IOP, the visual field and RN-FLT damage(P＜0.01). The sensitivity of ic-VEP to detect POAG was 90.2% and the specificity was 88.2% . Ic-VEP and the visual field, RNFLT had good consistency. Conclusion Ic-VEP has high sensitivity and accuracy in the diagnosis of primary open-angle glaucoma. Meanwhile ic-VEP SNR is associated with the damage of retinal nerve fiber layer and the visual field damage.