图形视觉诱发电位在急性视神经炎患者疗效评估中的应用价值

Evaluation Value of Pattern Visual Evoked Potential in Clinical Efficacy of Patients with Acute Optic Neuritis

目的:探讨图形视觉诱发电位(P-VEP)检查在评估急性视神经炎(AON)患者疗效中的临床意义。方法:回顾性分析2017年1月-2021年1月沈阳市第四人民医院收治的175例(263眼)AON患者的临床资料,根据治疗后临床效果分为有效组133例(201眼)和无效组42例(62眼),采用相关性分析探究患者治疗前P-VEP检查结果与治疗后最佳矫正视力(BCVA)、视野平均光敏感度(MS)、视野平均缺损(MD)的相关性。采用受试者工作特征曲线(ROC)分析P-VEP检查对AON患者临床疗效的评估价值。结果:有效组患眼治疗前P-VEP的P_(100)波振幅高于无效组,P_(100)波潜伏期低于无效组,差异均有统计学意义(P<0.05)。治疗前P_(100)波振幅与治疗后BCVA、视野MS呈正相关,与视野MD呈负相关(P<0.05);治疗前P_(100)波潜伏期与治疗后BCVA、视野MS呈负相关,与视野MD呈正相关(P<0.05)。ROC曲线分析显示,P_(100)波振幅、P_(100)波潜伏期预测AON临床疗效的曲线下面积分别为0.856、0.788,敏感度分别为88.71%、80.10%,特异度分别为82.59%、77.42%。结论:治疗前P-VEP检查可有效、客观地评估AON患眼治疗后视力、视野恢复情况,对临床疗效有较高的预测价值。

Objective:To explore the clinical significance of pattern visual evoked potential (P-VEP) in evaluating the clinical efficacy of patients with acute optic neuritis (AON).Method:The clinical data of 175 patients (263 eyes) with AON in the 4th People’s Hospital of Shenyang from January 2017 to January 2021 were retrospectively analyzed.They were divided into effective group (133 cases,201 eyes) and ineffective group (42 cases,62 eyes) according to the clinical efficacy after treatment.Correlation analysis was used to explore the correlation between P-VEP examination results before treatment and best corrected visual acuity (BCVA),mean sensitivity (MS) of visual field,mean deletion (MD) of visual field after treatment.The evaluation value of P-VEP in clinical efficacy of patients with AON was assessed by receiver operating characteristic (ROC) curve.Result:The amplitude of P_(100)wave of P-VEP before treatment in the effective group was higher than that in the ineffective group,and the latency of P_(100)wave was lower than that in the ineffective group,the differences were statistically significant (P<0.05).The amplitude of P_(100)wave before treatment was positively correlated with BCVA and MS of visual field after treatment,and was negatively correlated with MD of visual field after treatment (P<0.05).The latency of P_(100)wave before treatment was negatively correlated with BCVA and MS of visual field after treatment,and was positively correlated with MD of visual field after treatment (P<0.05).ROC curve analysis showed that the area under curve of P_(100)amplitude and latency in predicting the clinical efficacy of AON were 0.856 and 0.788,the sensitivity was 88.71% and 80.10%,and the specificity was 82.59% and 77.42%,respectively.Conclusion:P-VEP examination before treatment can effectively and objectively assess the visual acuity and visual field recovery in AON eyes after treatment,which has high predictive value for clinical efficacy.