综合视觉电生理检测对白内障术后视功能恢复的评估

Comprehensive examination of visual electrophysiology of visual function assessment after cataract operation

目的 评价术前综合视觉电生理检测在判断白内障手术视功能预后中的作用。方法 白内障患者 315例 (4 0 8眼 )术前常规检测图形翻转视觉诱发电位 (PVEP)、红蓝光视网膜电图 (FERG)和视网膜电图的振荡电位 (OPs)。正常对照组 16 2例 (2 6 6眼 )。术后检查眼底 ,术后 3mo查矫正视力。结果 术后矫正视力≥ 0 .5 ( 组 )和 <0 .5 ( 组 )者与对照组相比 ,术前 PVEP的 P1 0 0 波振幅均下降、潜伏期均延长 ,后组大多数还存在其他影响视功能因素 ,P1 0 0 波变化更加明显 ,2组间差异显著。 组术前红蓝光 ERG的 a、b波振幅和潜伏期与对照组相比无差异 ; 组红光 ERG的 a、b波振幅下降、潜伏期延长 ,蓝光 ERG的 a、b波振幅下降、潜伏期无延长 ; 组 OPs值较对照组下降与影响血液循环的眼底病变有关。结论 综合视觉电生理检测可以比较全面地反映视功能。术前各项均正常提示视功能预后好。术前 PVEP的 P1 0 0 波潜伏期延长、红光 ERG的 a、b波振幅下降及潜伏期延长、蓝光ERG的 a、b波振幅下降。

Objective To study the value of comprehensive examination of visual electrophysiology in prognosis of visual function after cataract operation.Methods 315 patients with cataract(408 eyes) underwent preoperative routine examination with pattern reversal visual evoked potential(PVEP), red and blue flicker electroretinogram(ERG) and oscillatory potential (OPs). Normal control group included 162 cases (266 eyes). All of the ocular fundi were examined postoperatively and corrected visual acuities were obtained 3 months after operation. Results Postoperative corrected visions ≥0.5(Ⅰ) and <0.5(Ⅱ) in case group compared with that in control group, amplitudes of PVEP P 100 wave decreased significantly and PVEP P 100 wave latency times prolonged significantly in group Ⅰ and Ⅱ. There was much more prominent changes in P 100 wave of group Ⅱ due to other factors influencing visual function. There wasn't significant difference of the amplitudes and the latency times of a wave and b wave of Red Blue ERG in group Ⅰ and the control group preoperatively. The amplitudes of a wave and b wave of Red ERG decreased, the latency times of a wave and b wave of Red ERG prolonged, the amplitudes of a wave and b wave of Blue ERG decreased but latency times didn' t prolong in group Ⅱ. The value of OPs decreased in groupⅡ compared with that of the control group, which was related to the retinopathy due to blood circulation obstruction.Conclusion Combined examination of visual electrophysiology can estimate visual function thoroughly. The prognosis will be good if various examinations are normal before operation, but will not be good if PVEP P 100 latency time prolong, the amplitudes of a wave and b wave of Red ERG decrease and the latency time prolong, the amplitudes of a wave and b wave of Blue ERG decrease and the value of OPs decrease.