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目的 评价图形视诱发电位(P -VEP)在甲状腺相关眼病视神经病变(DON)中的诊断价值及其影响因素。方法 对2 0 0 2年1月至2 0 0 3年12月收治的99例(188眼)TAO患者行常规P -VEP检查,比较矫正视力≥1. 0患眼与正常值之间以及矫正视力≥1 .0与<1. 0TAO患者之间P10. 0潜伏期及振幅变化;观察眶压、眼压及眼球突出对P10 .0潜伏期的影响;比较P -VEP与视野检查在DON中的诊断价值。结果 矫正视力≥1. 0组P10 .0平均潜伏期及振幅较正常值均有明显差异;视力≥1 .0组与<1 .0组比较,后者P10. 0潜伏期在中、高空间频率明显较前者延迟;眶压对P10. 0潜伏期影响最大;P -VEP较视野检查更灵敏,两者联合阳性率可达93 97%。结论 P -VEP视功能检查可以更敏感的较早发现DON的发生,并且可在一定程度上判断视神经的损伤程度;眶压在DON发生、发展中起关键性作用;P -VEP与视野检查联合应用可明显提高DON的诊断阳性率,是诊断DON较为灵敏和可靠的方法
Objective To evaluate the diagnostic value and influential factors of pattern visual evoked potential (P-VEP) in thyroid-associated ophthalmopathy (DON). Methods Totally 99 patients (188 eyes) with TAO admitted from January 2001 to December 2003 underwent routine P-VEP examination. The corrected visual acuity was compared with ≥1.0 between eyes and normal and corrected Visual acuity ≥1.0 and <1.0TAO patients with P10.0 latency and amplitude changes; observed orbital pressure, intraocular pressure and eyeball protrusion P10 .0 latency; compared P-VEP and visual field in the diagnosis of DON value. Results Correction of visual acuity ≥1.0 P10 .0 average latency and amplitude were significantly different from the normal; visual acuity ≥1.0 group and <1.0 group, the latter P10. 0 latency in the middle and high spatial frequency was significantly Lateral orbital pressure had the greatest effect on P10.0 latency; P-VEP was more sensitive than visual field test, and the positive rate of the combination of the two was 93.97%. Conclusions P-VEP can detect the occurrence of DON more sensitively and can determine the degree of optic nerve injury to a certain degree. Orbital pressure plays a key role in the occurrence and development of DON. P-VEP combined with visual field examination Application can significantly increase the diagnostic positive rate of DON, DON is more sensitive and reliable method of diagnosis