微视野与视诱发电位在黄斑病变中的法医学应用

摘要

Objective To find the correlation between real best corrected visual acuity (BCVA) and test-ing results of microperimetry and visual evoked potential (VEP) and to explore a newmethod in record-ing BCVAin macular disease. Methods Sixty-two patients with macular disease (macular disease group, 62 eyes) and eighteen healthy volunteers (control group, 36 eyes) had BCVA, microperimetry and VEP recorded. Results (1) By microperimetry, the values of retinal mean sensitivity and fixation percentage in macular disease group were lower than that in control group. The bicurve ellipse area in macular dis-ease group was higher than that in control group. By V EP, P100 amplitude under 0.5 cpd and 2 cpd in macular disease group were significantly higher than that in control group and the latency was prolonged (P<0.05). (2) In macular disease group, BCVAhad significant positive correlation with retinal mean sen-sitivity, bicurve ellipse area, macular central 2°and 4°fixation percentage, respectively (P<0.05). There was a significant correlation between retinal mean sensitivity and P100 amplitude (P<0.05). (3) multiple linear regression equation was y=0.053 x1+0.008 x3+3.897 (y was BCVA, while x1 was retinal mean sensi-tivity and x3 was P100 amplitude under 2 cpd). Conclusion C ombined use of microperimetry and VEP is useful in the assessment of BCVAin macular disease.%目的：研究微视野仪与视诱发电位检测结果与最佳矫正视力的相关性，探索检测眼底黄斑病变者最佳矫正视力的途径。方法对62例黄斑病变者（黄斑病变组，62眼）及18例健康志愿者（对照组，36眼）进行最佳矫正视力、微视野仪及视诱发电位的检测。结果（1）微视野仪检测示黄斑病变组视网膜平均敏感度、固视百分率均低于对照组，置信椭圆面积均大于对照组；视诱发电位检测示0.5周期/度（circle per degree，cpd）及2 cpd P100波振幅较对照组降低，潜伏期延长（P<0.05）。（2）黄斑病变组最佳矫正视力与其视网膜平均敏感度、置信椭圆面积及黄斑中心2°、4°固视百分率之间呈正相关性（P<0.05）。视网膜平均敏感度与P100波的振幅呈线性相关（P<0.05）。（3）多元线性回归方程为y=0.053 x1+0.008 x3+3.897（y为最佳矫正视力，x1、x3分别为视网膜平均敏感度与2 cpd P100波振幅）。结论联合使用微视野仪与视诱发电位有助于判断黄斑区视网膜病变患者的客观最佳矫正视力。