目的:应用图像视觉诱发电位(PVEP)对不同眼病患者和正常眼进行检查,了解PVEP在对不同眼病的评估中的意义。方法:用PVEP检查67例不同眼病患者及48名正常视力志愿者。比较分析不同病变的PVEP波形变化特点。结果:同正常眼相比,急性期中心性浆液性视网膜脉络膜病变眼、视野显著缩小的视网膜色素变性眼、视野显著缺损的开角型青光眼、外伤性视神经损伤眼以及弱视眼较正常对照眼PVEP的振幅明显下降,N1及P1的峰时延迟;而视野无显著缩小到视网膜色素变性眼以及视野轻度缺损的开角型青光眼N1峰时、P1峰时及振幅与无显著统计学差异。结论:PVEP对黄斑部功能受损的疾病改变十分敏感,而对周边视野损害改变不甚敏感,在PVEP波形两种成分的改变中振幅的改变较峰时更为敏感。在眼外伤视神经损伤的病例中PVEP可用于判断患眼视力的预后,在弱视病例中也有助于发现病患和随访治疗效果。

AIM:To observe the performance of pattern visual evoked potential(PVEP)in normal eyes and eyes with different diseases and learn the meaning of PVEP in the assessment of different eye diseases.METHODS:Sixty-seven patients with different eye diseases and 48 volunteers with normal visual acuity were examined by PVEP for comparative analysis of different changes in the waveform characteristics of PVEP in different eye diseases.RESULTS:Compared with the normal eyes,the PVEP amplitude of eyes with central serous choroidoretinopathy in acute phase,retinitis pigmentosa with significantly reduced visual field,open angle glaucoma with significant defect of visual field,traumatic optic neuropathy and amblyopia was decreased and latency was delayed,but the difference of the latency of P1 and N1,amplitude of(P1+N1) between normal eyes and eyes of retinitis pigmentosa without reduced visual field and open angle glaucoma without significant defect of visual field was not significant.CONCLUSION:PVEP is sensitive to macular disease,but is not sensitive to the peripheral visual field damage.Amplitude changes are more sensitive than the latency in the two components changes of PVEP waveform.PVEP can be used to determine the prognosis of patients visual acuity in ocular trauma cases with optic nerve damage and also help to identify patients and follow-up treatment effect in the amblyopic cases.

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中国上海市宝山区科委基金资助项目(No.03-A-28)~~