摘要
目的 探讨儿童视神经炎患儿视觉诱发电位( visual evoked potentials,VEP)的改变特点及应用价值.方法 应用美国NICOLET公司的诱发电位仪对33例儿童视神经炎患儿进行VEP测试,与头颅和(或)眼眶MRI及眼底检查结果比较,并与视力表现进行一致性分析,分析视敏感水平与VEP结果之间的相关性.结果 33例儿童视神经炎患儿,52只患眼中VEP异常率为88. 5%,头颅和(或)眼眶MRI的异常率为38. 5%,眼底检查的异常率为62. 2%,VEP检查异常率显著高于头颅和(或)眼眶MRI及眼底检查的异常率(P<0. 05). VEP检查与视力结果的符合率为84. 8%,其中图形翻转视觉诱发电位(pattern reversal visual evoked potential,P-VEP)检查与视力表现的符合率为86. 8%,闪光视觉诱发电位(flash visual evoked potential,F-VEP)检查与视力表现的符合率为82. 1%.随视力损害程度增加,P100波缺失比例呈逐渐增加趋势,视敏感水平与P100波潜伏期延长程度之间无相关关系.结论VEP与眼底检查及MRI结果之间均存在显著性差异,VEP敏感性优于二者. P-VEP相较于F-VEP,与视力表现的一致性更为显著. VEP对反映儿童视神经炎的视力损害程度有一定的价值.不能通过P100波潜伏期的延长程度判断视敏感的水平.
Objective To investigate the characteristics and clinical value of visual evoked potentials(VEP)in children with optic neuritis.Methods The VEP of 33 children with optic neuritis were tested by NICOLET evoked potential instrument.The results were compared with those of cranial and/or orbital MRI and fundus examination,and the consistency with visual performance was analyzed.The correlation between visual sensitivity and VEP results was analyzed.Results Among 33 children with optic neuritis,the abnormal rate of VEP in 52 abnormal eyes was 88.5%;the abnormal rate of cranial and/or orbital MRI was 38.5%;the abnormal rate of fundus examination was 62.2%;the abnormal rate of VEP examination was significantly higher than that of cranial and/or orbital MRI and fundus examination(P<0.05);the consistency rate between VEP examination and visual acuity was 84.8%.The consistency rate between pattern reversal visual evoked potential(P-VEP)and visual acuity was 86.8%,and that between flash visual evoked potential(F-VEP)and visual acuity was 82.1%.With the increase of visual impairment,the percentage of P100 wave loss increased gradually.There was no correlation between visual acuity and the prolongation of P100 wave latency.Conclusion There are significant differences between VEP and fundus examination and MRI,the sensitivity of VEP is superior to both.P-VEP is more consistent with visual acuity than F-VEP.VEP has certain value in evaluating the degree of visual impairment in children with optic neuritis.It can not be used to evaluate the level of optic sensitivity when the latency of P100 wave is prolonging.
作者
孙静
王昕
杨文民
王小月
杨健
Sun Jing;Wang Xin;Yang Wenmin;Wang Xiaoyue;Yang Jian(Department of Neurology,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国小儿急救医学》
CAS
2019年第11期840-845,共6页
Chinese Pediatric Emergency Medicine
基金
国家重点研发计划重大慢性非传染性疾病防控研究重点专项(2016YFC1306204)。
关键词
视神经炎
视觉诱发电位
视觉
儿童
Optic neuritis
Visual evoked potentials
Visual
Children
