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目的 探讨视觉诱发电位在初诊为视神经炎的急性视力下降患者病因诊断中的应用价值。设计 回顾性病例系 列。研究对象 66例(115眼)初诊为视神经炎的急性视力下降患者。方法 比较66例不同病因急性视力下降患者的图形翻转 视觉诱发电位(P-VEP)异常。主要指标 视觉诱发电位P100潜伏期和振幅。结果 P-VEP在特发性脱髓鞘性视神经炎 (IDON)、其他类型视神经炎、缺血性视神经病和压迫性视神经病中异常率分别为89．7％、93．7％、100．0％和60．0％;颅内疾病导 致的视盘水肿、心因性视力下降和原田氏病未发现VEP异常。P-VEP潜伏期延长在IDON、其他类型视神经炎、缺血性视神经病 分别为64．1％、62．5％和16．7％。P-VEP振幅下降在该三组则分别为30．7％、68．7％和83．3％。IDON组P-VEP潜伏期(152．0ms± 18．5ms)与其他类型视神经炎组(136．0ms±20．2ms)相比有显著性差异(t=3．603,P=0．01)。结论 P-VEP有助于急性视力下降 患者的病因诊断,并对鉴别不同病因的视神经病变有一定帮助。
Objective To investigate the value of visual evoked potentials in the etiological diagnosis of acute vision loss in newly diagnosed optic neuritis. Design retrospective case series. 66 cases (115 eyes) were newly diagnosed as optic neuritis in patients with acute vision loss. Methods Sixty-six patients with acute visual impairment of different etiology were retrospectively analyzed for abnormal visual evoked potentials (P-VEP). The main indicators visual evoked potentials P100 latency and amplitude. Results The abnormal rates of P-VEP in idiopathic demyelinating optic neuritis (IDON), other types of optic neuritis, ischemic optic neuropathy and compression ophthalmopathy were 89.7%, 93.7%, 100 respectively. 0% and 60.0%; disc edema caused by intracranial disease, decreased visual acuity and Harada disease found no VEP abnormalities. P-VEP latency was prolonged in IDON, other types of optic neuritis, ischemic optic neuropathy were 64.1%, 62.5% and 16.7%. The decrease in amplitude of P-VEP in the three groups was 30.7%, 68.7% and 83.3%, respectively. The latency of P-VEP in IDON group (152.0 ms ± 18.5 ms) was significantly different from that of other types of optic neuritis (136.0 ms ± 20.2 ms) (t = 3.603, P = 0.01). Conclusions P-VEP is helpful to diagnose the etiology of patients with acute vision loss and to help identify optic neuropathy of different etiologies.