VEP及ERG联合多焦视网膜电图在癔症性盲目诊治中的应用

VEP and ERG combined with multifocal electroretinography in diagnosis of hysteria blindness

目的 :探讨视觉诱发电位 (VEP)和闪光视网膜电图(F ERG)联合多焦点闪光视网膜电图 (mERG)在癔症性盲目中的诊断作用 .方法 :对有明确精神因素诱因的 12例双眼视力突然降低 ,怀疑为癔症性盲目的患者 ,按照国际临床视觉电生理学会的标准化指导方案 ,进行常规VEP ,ERG和mfERG测定 ,分析P VEPP10 0波潜伏期和振幅、F VEP幅值和潜伏期、F ERGa波、b波潜伏期和振幅 ,以及mERG总值和中心点的幅值 ,并与以本实验室制定的同年龄组的正常值作为对照进行分析 .同时进行神经内科、精神科、眼科检查和辅助检查 .结果 :12例患者均为年轻女性 ,平均年龄 2 2岁 ,就诊视力无光感 (NLP)～ 0 .0 3,5例患者有视野改变 ,眼科裂隙灯和眼底镜检查结果未见异常 ,神经内科、精神科和辅助检查排除了器质性病变可能性 .视觉电生理各项指标与对照组比较均无异常 ,表明患者视网膜和视觉传导通路功能正常 .经暗示治疗 10例视力恢复正常 (>1.0 ) ,2例视力提高至原视力水平 (0 .8) ,证实了癔症性盲目的诊断 .结论 :VEP ,ERG和mERG能够对患者视网膜及视路功能进行比较全面和客观的评定 ,为癔症性盲目的诊断提供了重要的客观依据 .

AIM: To investigate the diagnostic value of visual evoked potentials (VEP), flash electroretinogram (F-ERG) and multifocal electroretinography (mERG) in hysteria blindness. METHODS: VEP, ERG and mfERG were recorded in twelve female patients with an average age of 22 years, whose eyesights suddenly reduced with clear spiritual factor inducement and who were suspected of hysteria blindness. The implicit times and amplitudes of P-VEP P100, F-VEP, F-ERG a/b waves, and the amplitude of total and central point in mERG were analyzed. Normal values of the same age group that has been established by our laboratory were used as controls. The neurological examination, psychiatric examination, ophthalmologic examination and other auxiliary examinations were also conducted. RESULTS: The visual acuity was from NLP to 0.03. Five patients had vision field changes. The examination results of slit lamp and ophthalmoscope were normal, and neurological examination, psychiatric examination, ophthalmological examination and other auxiliary examinations excluded the possibility of organic diseases. No difference was found in the indexes of visual electrophysiology between the patient group and control group, which indicated that the function of patient's retina and visual transmit was normal. After a suggestive therapy, 10 of them returned to normal eyesight and 2 recovered to the original eyesight level, which confirmed the diagnosis of hysteria blindness. CONCLUSION: VEP, ERG and combined with mERG can provide an important objective basis for the diagnosis of hysteria blindness.