图形翻转视觉诱发电位对轻度白内障术后视功能预测的价值

Pattern reversal visual evoked potential examination in the prediction of the post-operative vision acuity of age-related cataract patients

目的探讨轻度年龄相关性白内障患者术前图形翻转视觉诱发电位(PR-VEP)检查与术后最佳矫正视力之间的相关性,评价PR-VEP在轻度年龄相关性白内障患者手术后视力预后中的预测作用。方法收集2017年1~12月115例在我科诊断为年龄相关性白内障的患者,晶状体混浊分类标准(LOCS)Ⅲ分级均小于N3C3P2,行白内障超声乳化+人工晶状体植入术,收集患者术前资料,行PR-VEP检查。结果根据术后1个月最佳矫正视力(BCVA)将患者分为低视力组(BCVA≤0.5)、中视力组(0.5<BCVA≤0.8)及高视力组(BCVA>0.8)3组,以PR-VEP中N75波潜伏期、P100波潜伏期及振幅、N135波潜伏期等作为检测指标,采用t检验分析各组术前的PR-VEP参数是否存在差异。N75波潜伏期在术后低视力组中为(80.52±11.03)ms,较中视力组[(2.47±12.00)ms]及高视力组[(72.21±12.87)ms]有明显延长,差异有统计学意义(P<0.01)。P100波潜伏期在术后低视力组中为(114.35±13.29)ms,较中视力组[(106.84±13.43)ms]及高视力组[(104.21±14.88)ms]有明显延长,差异有统计学意义(P=0.016,P<0.01)。P100波振幅在术后低视力组患者中为(3.37±1.72)μV,较中视力组[(4.77±2.36)μV]及高视力组[(6.02±2.46)μV]有明显下降,差异有统计学意义(P<0.01)。结论PR-VEP在轻度白内障患者术后视力预估中有一定的参考价值,其中N75与P100波潜伏期延长伴P100波振幅下降提示轻度年龄相关性白内障患者术后视力预后不良可能性较大。

Objective To investigate the correlation between preoperative pattern reversal visual evoked potential(PR-VEP)and best corrected visual acuity(BCVA)and to evaluate the predictive role of PR-VEP in vision prognosis after surgery in patients with mild age-related cataract.Methods From January to December 2017,115 patients diagnosed with age-related cataract in our department were collected.All of them were LOCS III grade less than N3C3P2.Cataract phacoemulsification with IOL implantation were performed.Preoperative data were collected and PR-VEP examination was performed.Results The patients were divided into low vision group(BCVA≤0.5),medium vision group(0.5<BCVA≤0.8)and high vision group(BCVA>0.8)according to the BCVA 1 month after surgery.The N75 wave latency,P100 wave latency and amplitude,and N135 wave latency in PR-VEP were used as detection indexes,and t test was used to analyze whether the preoperative PR-VEP parameters of each group were different.The incubation period of N75 wave was(80.52±11.03)ms in the low-vision group,and was significantly longer than that of the middle-vision group[(72.47±12.00)ms]and the high-vision group[(72.21±12.87)ms](P<0.01).The latency of P100 wave was(114.35±13.29)ms in the low vision group,which was significantly longer than that in the medium vision group[(106.84±13.43)ms]and the high vision group[(104.21±14.88)ms](P=0.016,P<0.01).The amplitude of P100 wave was(3.37±1.72)μV in the low vision group after surgery,and significantly decreased compared with the medium vision group[(4.77±2.36)μV]and the high vision group[(6.02±2.46)μV](P<0.01).Conclusions PR-VEP has a certain reference value in the prediction of postoperative vision in patients with mild cataract,among which the prolonged latency period of N75 and P100 wave and the decreased amplitude of P100 wave suggest that patients with mild age-related cataract have a higher probability of poor postoperative vision prognosis.