视觉诱发电位分离格栅模式对原发性开角型青光眼的诊断效能分析

Diagnostic efficiency evaluation of isolated-check visual evoked potential on primary open-angle glaucoma

目的评价视觉诱发电位分离格栅模式(Ic-VEP)在原发性开角型青光眼(POAG)诊断中的准确度、灵敏度及特异度。方法选取自2014年11月至2023年2月就诊于中国医科大学附属第四医院眼科的POAG患者52例(104眼)作为POAG组,按照单纯随机抽样原则抽取同时段非青光眼患者40例(80眼)作为对照组。采用柯谛亚视觉电生理检测仪及Humphery自动视野计检测Ic-VEP信噪比和平均偏差等指标。通过绘制受试者操作特征(ROC)曲线,计算曲线下面积(AUC),评估Ic-VEP在POAG中的诊断效能。结果Ic-VEP定性检查的灵敏度为92.3%,特异度为80.0%,准确度为88.0%,AUC为0.873(95%CI:0.793~0.953);IcVEP定量检查的灵敏度为91.3%,特异度为81.3%,准确度为87.0%,AUC为0.863(95%CI:0.804~0.922);Ic-VEP定性、定量检查结果分析显示,早期POAG灵敏度(81.3%,88.4%)均略低于中晚期(82.0%,93.4%),但差异无统计学意义(χ^(2)=0.001,P=0.981;χ^(2)=0.037,P=0.847)。结论Ic-VEP对POAG具有良好的诊断效能,不仅对中晚期POAG具有诊断意义,还可早期发现POAG。

Objective To evaluate the accuracy,sensitivity,and specificity of isolated-check visual evoked potential(Ic-VEP)in the diagnosis of primary open-angle glaucoma(POAG).Methods The participants were 52 patients(104 eyes)with POAG and 40 healthy controls(80 eyes).All participants were examined using Ic-VEP and Humphrey perimetry to record the signal-to-noise ratio and mean deviation.Receiver operating characteristic(ROC)curve analysis was used to characterize the diagnostic performance of Ic-VEP in POAG.Results The sensitivity,specificity,and accuracy of the Ic-VEP qualitative examination were 92.3%,80.0%,and 88.0%,respectively.The area under the curve(AUC)was 0.873(95%CI:0.793-0.953).The sensitivity,specificity,and accuracy of the Ic-VEP quantitative examination were 91.3%,81.3%,and 87.0%,respectively.The AUC was 0.863(95%CI:0.804-0.922).The sensitivity of Ic-VEP in the early stage of POAG(81.3%)was slightly lower than that in the middle and late stages(82.0%),but the difference was not statistically significant(χ^(2)=0.001,P=0.981).The sensitivity of Ic-VEP quantitative examination in the early stage of POAG(88.4%)was slightly lower than that in the middle and late stages(93.4%);however,the difference was not statistically significant(χ^(2)=0.037,P=0.847).Conclusion Ic-VEP is an effective diagnostic instrument for middle-late and early stages of POAG.