超高度近视眼黄斑部视网膜厚度与视觉诱发电位测定分析

Detection of ultra-high myopia macular retinal thickness and visual evoked potential analysis

目的检测超高度近视眼屈光度数、黄斑中心凹视网膜神经上皮层厚度及图像视觉诱发电位(PVEP)各波的反应振幅与潜伏期,并与正常人比较,评价其差异。方法选择残疾鉴定工作中超高度近视患者20例(40眼)和正常对照组20例(40眼),用综合验光法验光,光学相干断层扫描仪(optical coherence tomography,OCT)测量黄斑中心凹神经上皮层厚度,图像视觉诱发电位(PVEP)测量各波的反应振幅与潜伏期,分析超高度近视眼屈光度数、中心凹部神经上皮层厚度及PVEP各波的反应振幅与潜伏期关系。结果超高度近视眼平均眼屈光度数为(18.30±4.67)D,与对照组比较,差异有统计学意义;黄斑中心凹平均神经上皮层厚度为(158.54±6.82)μm,与对照组比较,差异有统计学意义;PVEP各波的反应潜伏期N75波为(85.26±2.95)ms,P100波为(120.97±10.58)ms,N145波为(153.66±9.03)ms,P100波振幅(5.12±2.03)uv,同对照组相比,各波反应潜伏期明显延迟,振幅低平,差异有统计学意义。结论超高度近视眼与正常眼相比,眼屈光度数越大,黄斑区神经上皮层厚度明显变薄,图像视觉诱发电位(PVEP)各波的反应振幅与潜伏期明显较正常眼差,提示视网膜神经上皮通路功能明显受损。

Objective To detection of high myopia refraction, foveal retinal nerve layer thickness, pattern visual evoked potential （PVEP） wave response amplitudes and latency. They were compared with the normal patients. Methods 20 eases with super high myopia patients and normal control group of 20 eases were selected. Fovea nerve layer thickness was measured using optical coherence tomography; picture visual evoked potential（PVEP） measured the response amplitude and latency phase of each wave. Results Average eye refraction of ultra-high myopia patients was 18.30 ±4.67 D, the difference was statistically significant compared with the control group; foveal nerve cortical thickness was 158.54 ± 6.82, the difference was statistically significant; N75 wave latency was 75.26 ± 4.95 ms, P100 wave latency was 120.97 ±10.58 ms, N145 wave latency was 153.66±9.03 ms, P100 wave amplitude was （5.12 ± 2.03） UV in PVEP wave. Each wave latency phase was significantly delayed and the amplitude was decreased. Conclusion Retinal nerve layer thiekness was significantly thinner in the maeular region in ultra-high myopia patients compared with the normal group. Response amplitude and latency phase of image visual evoked potential （PVEP） wave were worse than normal eye groups. Our results showed that the function of retinal neuroepithelial pathway was significantly impaired.