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目的探讨扫描翻转图形视觉诱发电位(SPVEP)在弱视儿童客观视力评估的可行性。设计前瞻性病例研究。研究对象80例(148眼)弱视儿童及26例(52眼)正常视力儿童。方法弱视儿童进行扫描图形翻转视觉诱发电位视力(SPVEP-A)与国际标准E字视力检测;正常视力儿童进行SPVEP-A、传统瞬态图形视觉诱发电位(PVEP)视力(PVEP-A)与E字视力检测,对检测结果进行相关性分析。使用LKC公司UTES-E3000型视觉电生理仪检测SPVEP,选用0.2～18.8epd的25个空间频率正弦光栅连续刺激视网膜,经离散傅立叶分析,获得振幅。空间频率曲线,并将相关直线外推至0振幅,获得SPVEP视力。在PVEP检测中将典型VEP波形的最高空间频率作为PVEP视力。主要指标SPVEP-A、PVEP-A和E字视力。结果弱视患者矫正视力在0.1～0.8之间,SPVEP-A在0.35～0.9之间,SPVEP-A与E字视力的相关系数r=0.602(P<0.01)。SPVEP-A两次重复检测的相关系数r=0.448。轻度弱视SPVEP-A与E字视力的相关性(r=0.773)优于中重度弱视者(r=0.590)。正常儿童SPVEP-A与E字视力的相关系数r=0.424,PVEP-A与E字视力的相关系数r=0.679。SPVEP-A与E字视力比较存在高估、低估现象,在E字视力的低视力段,SPVEP-A存在高估现象;在E字视力的高视力段,SPVEP-A存在低估现象。结论扫描翻转图形视觉诱发电位是筛查弱视儿童客观视力的一种疗法。SPVEP-A与E字视力存在明显的正相关,但变异较大,应进一步提高检测的稳定性与准确性。
Objective To investigate the feasibility of scanning flip-flop visual evoked potentials (SPVEP) in assessment of objective visual acuity in children with amblyopia. Design prospective case studies. The study included 80 children (148 eyes) with amblyopic eyes and 26 eyes (52 eyes) children with normal eyesight. Methods Visual evoked potential visual acuity (SPVEP-A) and international standard E-word visual acuity (FVTPA) were examined in children with amblyopia. PVV-A and PVEP- Word vision test, test results for correlation analysis. The SPVEP was detected by UTEC-E3000 visual electrophysiology instrument of LKC Company, and the retina was continuously stimulated by 25 spatial frequency sine rasters of 0.2-18.8 epd. The amplitude was obtained by the discrete Fourier analysis. Spatial frequency curve, and the relevant line extrapolated to 0 amplitude, to obtain SPVEP vision. The PVEP visual acuity is the highest spatial frequency of a typical VEP waveform in PVEP testing. The main indicators of SPVEP-A, PVEP-A and E visual acuity. Results The corrected visual acuity of amblyopia patients was between 0.1 and 0.8. The SPVEP-A was between 0.35 and 0.9. The correlation coefficient between SPVEP-A and E-word vision was 0.602 (P <0.01). The correlation coefficient of two repeated tests of SPVEP-A was r = 0.448. Mild amblyopia SPVEP-A and visual acuity (r = 0.773) was better than moderate to severe amblyopia (r = 0.590). The normal children SPVEP-A and E-word correlation coefficient r = 0.424, PVEP-A and E-word vision correlation coefficient r = 0.679. There is overestimation and underestimation of visual acuity in SPVEP-A and E words. In the low visual acuity of E word vision, SPVEP-A is overestimated. In the high visual acuity segment of E word, SPVEP-A is underestimated. Conclusion Scanning Flip Pattern Visual Evoked Potentials is a therapy for screening objective visual acuity in children with amblyopia. There was a significant positive correlation between SPVEP-A and E-word visual acuity, but the variation was larger. The stability and accuracy of SPVEP-A should be further improved.