摘要目的 对比近视性、远视性、散光性弱视患儿治疗前后的图形翻转视觉诱发电位(PRVEP),探讨不同性质屈光不正性弱视的治疗效果.方法 筛选2009年5月至2011年5月本院诊治的年龄6～7岁的弱视患儿90例,分为近视性、远视性及混合散光性3组,每组各30例60只眼,30例健康儿童60只眼作为对照,采用视觉诱发电位仪作PR-VEP检测,记录并比较弱视治疗前后各组P100潜伏期和P波振幅的变化.结果 治疗前,与健康儿童组比较,3组弱视眼组PR-VEP的P100潜伏期延长,P波振幅下降.与远视性弱视组和散光性弱视组相比,近视性弱视组P100潜伏期最长(均P＜0.05),P波振幅最低(均P＜0.05),而远视性弱视组和散光性弱视组之间差异无统计学意义.与治疗前比较,3组弱视患儿弱视眼在治疗之后P100的潜伏期缩短,P波振幅上升.近视性、远视性及混合散光性3组弱视患儿治疗前后的潜伏期差值和振幅差值之间差异也有统计学意义[潜伏期差值:(2.640±0.009) ms比(5.590±0.576)ms比(6.989±2.229)ms,振幅差值:(0.929±0.611)μV比(2.595±0.464) μV比(2.575±0.211)μV,均P＜0.05],近视性弱视的潜伏期差值和振幅差值最小.结论 近视性弱视治疗前后的潜伏期差值和振幅差值最小,证实了近视性弱视的难治性.PR-VEP检测对弱视的临床治疗具有指导意义.

abstractsObjective To compare the features of pattern reversal visual-evoked potential (PRVEP) in children with myopic,hypermetropic and astigmatical amblyopia and the effect of treatment on PRVEP.Methods Ninty children (180 eyes) with amblyopia at 6 to 7 years of age were recruited from Guangzhou Women and Children' s Medical Center between May 2009 and May 2011 and were assigned to myopic (n=30,60 eyes),hypermetropic (n=30,60 eyes) and astigmatical (n=30,60 eyes) amblyopia group respectively.Thirty normal healthy children (60 eyes) were served as normal controls.PR-VEP examination was undertaken for comparison on the latency period of P100 and changes in amplitude of P wave piror to and after treatment.Results Children with amblyopia were associated with prolonged latency period of P100 for PR-VEP and reduced amplitude of P wave as compared with normal controls.Children with myopic amblyopia possessed the longest latency period of P100 and the lowest amplitude of P wave (both P＜0.05),followed by those with hypermetropic and astigmatical amblyopia (P＞0.05 for between-group comparison).Shortened latency period of P100 and increased amplitude of P wave were noted after the treatment in children with amblyopia.The differences in pre-and post-treatment latency period of P100 and amplitude of P wave reached statistical significance among the three groups [for the difference in latency period:(2.640±0.009 ms vs (5.590±0.576)ms vs (6.989±2.229)ms,for the difference in amplitude of P wave:(0.929 ± 0.611) μV vs (2.595 ± 0.464) μV vs (2.575 ± 0.211) μV,all P＜0.05].Children with myopic amblyopia were featured by the lowest difference in latency period and amplitude.Conclusion The fact that children with myopic amblyopia have the lowest difference in latency period and amplitude proves the refactory treatment.Asessment of PR-VEP is clinically important to the treatment of amblyopia.