视觉电生理测定对视网膜挫伤程度及预后的评价

Assessment of the degree and prognosis of retinal contusion by visual electrophysiology

目的 :观察视觉电生理在评价视网膜挫伤程度及预后的作用。方法 :检测眼挫伤 12 7例 F- ERG、视觉诱发电位 (VEP)结果 ,运用非参数检验、χ2检验等方法分析视觉电生理改变与视网膜挫伤程度及视力变化的关系。结果 :(1)视网膜挫伤组 ERG a波、b波的振幅下降、峰时值延长 ,较对照组差异有极显著性 (P<0 .0 1) ;(2 )初诊视力 <0 .0 5、0 .0 5～ 0 .2 5、≥ 0 .33组之间及视网膜挫伤轻度、中度、重度 3组之间 ERG a波、b波振幅及峰时值差异均有极显著性 (P<0 .0 1) ;(3) ERG测定结果与治疗后视力变化有明显联系 ,Spearman相关系数 rs为 - 0 .5 31;(4) ERG单独检测的异常率为 74 .0 2 % ,ERG与 VEP联合检出的异常率为 93.70 % ,二者比较差异有极显著性 (P<0 .0 1)。结论 :ERG对视网膜挫伤程度及预后的评价有重要价值 ,而 ERG与 VEP联合检查 。

Objective:To observe the value of visual electrophysiology in assessment of the degree and prognosis of retinal contusion.Methods:127 patients' clinical records and the results of F-ERG,VEP were reviewed retrospectively.Relations of the electro-physiologic change with the degree and visual acuity changes of retinal contusion were analysed by statistical methods(Nonparametric Test,Chi-square Test,et al).Results:There were significant differences of the F-ERG(the amplitudes and the peck times of a-wave,b-wave) between the retinal contusion group and the normal contrast group(P<0.01).There were significant differences of the F-ERG among 3 groups of the initial visual acuity(<0.05,0.05~0.25,≥0.3) and among 3 groups of retinal contusion(light,moderate,heavy)(P<0.01).Therefore the final visual acuity was correlated with the result of the F-ERG.The relative coefficient egnaled -0.531.The abnormal rate of F-ERG is 74.02%.And when F-ERG allies with VEP,it can achieve 93.70%.Conclusion:The ERG possessed significant value to the assessment of the degree and prognosis of retinal contusion.The combination of ERG and VEP was of more objective value of predicting the eye bruise outcome.