分离格栅视觉诱发电位与蓝黄视野检查诊断开角型青光眼的性能比较

目的:评估分离格栅视觉诱发电位(IC-VEP)在诊断开角型青光眼中的表现,并将其与蓝黄色视野检查法(B/YP)和光学相干断层扫描(OCT)进行比较。方法:通过回顾性分析,对来自中国的101例受试者(正常组35例;早期青光眼30例,中晚期青光眼患者36例)分别进行IC-VEP、蓝黄色视野检查和OCT等检查。计算IC-VEP、视野检查法和OCT对检测青光眼的敏感度以及这三种方法之间的一致性,以评估其临床表现。结果:早期POAG组的IC-VEP、蓝黄色视野检查和OCT的敏感度分别为70.00%、70.00%、63.33%。在中晚期POAG组中,IC-VEP、OCT和蓝黄色视野检查的敏感度分别为86.11%、88.89%、91.67%。其中IC-VEP的特异性为91.43%。IC-VEP的结果与OCT和蓝黄色视野测试高度一致(kappa:0.721~1.000,P<0.05)。结论:作为视觉功能的客观检查手段,IC-VEP可用于青光眼的早期诊断,也可用于监测可疑青光眼患者的RGC功能。

Diagnostic performance of isolated-check visual evoked potential versus perimetry with blue-yellow in patients with open angle glaucoma

AIM: To evaluate the diagnostic performance of the isolated-checked visual evoked potential(IC-VEP)in the detection of open angle glaucoma and compared it to the blue-yellow perimetry(B/YP)and optical coherent tomography(OCT).

METHODS: In a retrospective analysis, IC-VEP, perimetry and OCT were performed on 101 subjects(n=35, normal; n=30, early glaucoma; n=36, moderate and advanced glaucoma)from China. The sensitivity of IC-VEP, perimetry and OCT for detection of glaucoma, as well as the agreement within these 3 methods, were calculated to evaluate their clinic performance.

RESULTS: In the early primary open angle glaucoma(POAG)group the sensitivity of IC-VEP, blue-yellow perimetry and OCT were 70.00%, 70.00% and 63.33%, respectively. In the moderate advanced POAG group, the sensitivity of IC-VEP, OCT and blue-yellow perimetry were 86.11%, 88.89% and 91.67%, respectively. The specificity of IC-VEP was 91.43%. The results of IC-VEP were highly consistent with OCT and blue-yellow visual field tests(kappa: 0.721-1.000, P<0.05).

CONCLUSION:As an objective examination of visual function, IC-VEP can be used for early diagnosis of glaucoma. It may be a useful tool for monitoring the function of RGCs in suspected glaucoma patients.