年龄对屈光不正性弱视儿童图形视觉诱发电位的影响

Analysis of the characteristics of pattern visual evoked potentials in different age groups of children with ametropic amblyopia

目的 分析屈光不正性弱视儿童图形视觉诱发电位（PVEP）检测结果的特点及年龄对其的影响.方法 回顾性系列病例研究.等效球镜为远视的屈光不正性弱视患儿92例（184眼）,按最佳矫正视力0.8～0.6、0.5～0.2、≤0.1三个级别分为轻度弱视组108眼,中度弱视组65眼,重度弱视组11眼.每组又以6岁为界进行分组,分为＜6岁组和≥6岁组.采用视觉电生理检查系统检测PVEP,对弱视组间差异行单因素方差分析,同一程度弱视组中的不同年龄组间行独立样本t检验,比较不同弱视程度组间及不同年龄组间P100波潜伏期（LP100）及振幅（AP100）的差异.结果 随弱视程度加重,PVEP的LP100延长,三组间差异有统计学意义（F=151.30,P＜0.01）,两两间差异均有统计学意义（P＜0.01）.三组间AP100差异有统计学意义（F=13.59,P＜0.05）,两两比较示,重度组的AP100明显较其余两组低,差异有统计学意义（P＜0.01）,中度组较轻度组低,但差异无统计学意义.轻度组中,年龄≥6岁组与＜6岁组比较,LP100明显延长,AP100降低,差异有统计学意义（t=5.08、7.45,P＜0.01）；中度组也呈类似表现（t=4.68、4.27,P＜0.01）；重度组结果类似,但由于例数少,未进行统计分析.结论 PVEP的LP100、AP100可作为衡量儿童屈光不正性弱视严重程度的客观指标,同时对结果进行分析时应充分考虑年龄的影响.

Objective To analyze the characteristics of pattern visual evoked potentials （PVEPs） and the effect of age in children with ametropic amblyopia.Methods Ninety-two children （184 eyes） with hyperopic amblyopia （spherical equivalent refractions） were analyzed retrospectively.Subjects were categorized into three groups based on the best corrected visual acuity （BCVA）： mild amblyopia group （0.8-0.6）,108 eyes; moderate amblyopia group （0.5-0.2）,65 eyes; severe amblyopia group （BCVA≤0.1）,11 eyes.Each group was further divided into two subgroups based on age： 〈6 years and ≥6 years. PVEPs were collected with a visual electrophysiological examination system. The differences between the latency （LP100） and amplitude （AP100） of the PVEP among different amblyopie groups and age subgroups were compared statistically with a one-way ANOVA and an independent samples t test.Results With an increase in the degree of amblyopia, the LP100 of the PVEP increased and the AP100 of the PVEP decreased.The differences between groups in the LP100 of the PVEP were statistically significant （F=151.30,P〈0.01）.The differences between every two groups were statistically significant （P〈0.01）.The differences between groups in the AP100 of the PVEP were statistically significant （F=13.59,P〈0.05）.The differences between severe amblyopia and the other two groups were statistically significant （P〈0.01）,but no statistically significant differences were found between the moderate and mild groups.Within the mild and moderate amblyopic groups,the LP100 of the ≥6 years of age group were longer than those of the 〈6 years of age group,and the AP100 of the former were less than those of the latter.The differences were statistically significant （mild group： t=5.08, 7.45, P〈0.01; moderate group： t=4.68, 4.27, P〈0.01）.The severe group showed similar results but without statistical analysis due to fewer cases.Conclusion The LP100 and AP100 of the PVEP can be used to objectively assess the degree of ametropic amblyopia in children while the influence of age should also be considered.