视觉诱发电位和黄斑区神经节细胞内丛状层厚度在原发性开角型青光眼早期诊断中的相关性

Correlation between visual evoked potentials and macular ganglion cell-inner plexiform layer in early diagnosis for primary open-angle glaucoma correlation

目的探讨分离格栅视觉诱发电位(IC-VEP)和黄斑区神经节细胞内丛状层(GCIP)厚度改变在原发性开角型青光眼(POAG)早期诊断中的相关性,为提高POAG早期诊断效能和速率提供理论依据。方法病例对照研究。收集2017年3月至2019年4月在石家庄市人民医院住院治疗的POAG早期患者(观察组)31例(31只眼),平均年龄(43.11±5.34)岁;正常受试者(对照组)30例(30只眼),平均年龄(42.88±5.15)岁。两组受试者均行Humphrey视野、HD-OCT及IC-VEP检测,统计分析两组受试者基线资料、各参数诊断效能以及SNR和GCIP厚度变化相关性。结果两组受试者性别、年龄、最佳矫正视力、屈光度和中央角膜厚度的差异均无统计学意义(P﹥0.05),视野平均缺损变化(P﹤0.01)。观察组IC-VEP和HD-OCT检测的敏感性及特异性分别占83.87%和90%,80.64%和86.67%,组间比较(均P﹥0.05)。两组受试者的一致性检测率为65.57%。观察组和对照组信噪比(SNR)值分别为(0.92±0.05和1.37±0.16),差异有统计学意义(P﹤0.01)。观察组黄斑区不同部位GCIPL厚度均明显变薄(均P﹤0.05)。观察组SNR和黄斑区不同部位GCIPL均呈正相关(均P﹤0.05)。结论视觉诱发电位和黄斑区神经节细胞内丛状层厚度在POAG早期的一致性变化,将进一步提高POAG早期诊断效能和速率,延缓并降低青光眼盲的发生率。

Objective To analyze and evaluate the correlation between the isolatedcheck visual evoked potentials(ic-VEP)and thickness of the macular ganglion cell-inner plexiform layer(GCIPL)in early diagnosis of primary open-angle glaucoma(POAG)and provide a theoretical evidence for improving the efficiency of diagnosis in early POAG.Methods A clinical case-control study.31 eyes of 31 patients with POAG(Observed group)and 30 eyes of 30 normal persons(Control group)were collected in our hospital from March 2017 to April 2019.The average age was(43.11±5.34)years and(42.88±5.15)years in the observed group and control group,respectively.The HUMPhrey visual field,HD-OCT,and IC-VEP were performed for all subjects.The baseline data of two groups were evaluated with statistics and each parameter was evaluated for its diagnostic efficacy.The correlation of changes in SNR and GCIP thickness was analyzed.Results There was no statistical difference in gender,age,best corrected visual acuity,refractive diopter,and central corneal thickness between the two groups of subjects(P﹥0.05).The statistically significant difference was found in MD between the two groups(P﹤0.05).The sensitivity and specificity of IC-VEP and HD-OCT in early POAG patients were 83.87%and 90%,80.64%and 86.67%,respectively.Also,these changes were not different.The detection rate of consistency was 65.57%in the two groups.The SNR values of the observation group and the control group were(0.92±0.05 and 1.37±0.16),respectively,the difference was statistically significant(P﹤0.01).In the observation group,the thickness of GCIPL in different parts of the macular area was significantly thinner(all P﹤0.05).The positive correlations between SNR and GCIPL in different parts of the macular area were found in the observation group(all P﹤0.05).Conclusions The consistent changes in the visual evoked potential and the thickness of the plexiform layer in the ganglion cells of the macular area at the early stage of POAG will further improve the early diagnosis efficiency and rate of POAG,delay and reduce the rate of glaucomatous blindness.