CAJ | 학술논문

目的：通过观察比较已治愈弱视患儿与正常视力儿童的图形视觉诱发电位(pattern visual evoked potential， P-VEP)，寻求一种客观评价儿童视功能及预测弱视疗效的手段，并且进一步观察影响P-VEP的相关因素，为进一步探讨弱视的发病机制提供临床依据。方法：将60例8~12岁经正规弱视治疗后弱视治愈儿童分为单眼弱视治愈组(40人，弱视治愈眼40只，而另眼为相对正常眼40只)及双眼弱视治愈组(20人40只眼)。20例视力正常的同龄儿童为正常对照组。比较3组P-VEP的潜伏期和振幅，并通过线性回归分析影响P-VEP的相关因素。结果：3组双眼矫正视力比较差异均无统计学意义(P>0.05)。单眼弱视治愈组及双眼弱视治愈组的弱视眼P100波较正常组潜伏期延长、振幅降低；其中单眼弱视治愈组弱视眼明显低于双眼弱视治愈组。单眼弱视治愈组的相对正常眼P100波较正常组潜伏期延长、振幅降低，而与双眼弱视治愈组比较差异无统计学意义(P>0.05)，与自身弱视眼比较P100波潜伏期缩短、振幅增加(P<0.05)。线性回归分析结果显示影响弱视眼P100潜伏期的主要相关因素是初治矫正视力、初治年龄及屈光度。结论：通过弱视治疗，虽然患儿视力恢复正常，但弱视眼及相对正常眼的视功能仍未恢复正常；初治矫正视力、初治年龄及屈光度对患儿视力及视功能恢复均有重要影响；仅针对增加视力的传统弱视治疗对于提高双眼视功能仍有不足。
목적：통과관찰비교이치유약시환인여정상시력인동적도형시각유발전위(pattern visual evoked potential， P-VEP)，심구일충객관평개인동시공능급예측약시료효적수단，병차진일보관찰영향P-VEP적상관인소，위진일보탐토약시적발병궤제제공림상의거。방법：장60례8~12세경정규약시치료후약시치유인동분위단안약시치유조(40인，약시치유안40지，이령안위상대정상안40지)급쌍안약시치유조(20인40지안)。20례시력정상적동령인동위정상대조조。비교3조P-VEP적잠복기화진폭，병통과선성회귀분석영향P-VEP적상관인소。결과：3조쌍안교정시력비교차이균무통계학의의(P>0.05)。단안약시치유조급쌍안약시치유조적약시안P100파교정상조잠복기연장、진폭강저；기중단안약시치유조약시안명현저우쌍안약시치유조。단안약시치유조적상대정상안P100파교정상조잠복기연장、진폭강저，이여쌍안약시치유조비교차이무통계학의의(P>0.05)，여자신약시안비교P100파잠복기축단、진폭증가(P<0.05)。선성회귀분석결과현시영향약시안P100잠복기적주요상관인소시초치교정시력、초치년령급굴광도。결론：통과약시치료，수연환인시력회복정상，단약시안급상대정상안적시공능잉미회복정상；초치교정시력、초치년령급굴광도대환인시력급시공능회복균유중요영향；부침대증가시력적전통약시치료대우제고쌍안시공능잉유불족。
Objective:To evaluate the clinical significance of pattern visual evoked potential (P-VEP) parameters on amblyopic patients with normal-vision atfer pleoptic therapy. Methods:We investigated 60 amblyopic children (8-12 years old) who gained normal-vision atfer pleoptic therapy. hTese patients were assigned to a unilateral amblyopia group (40 patients)and a bilateral amblyopia group (20 patients). Another 20 healthy children served as a control group. All patients underwent a full initial ophthalmologic and orthoptic evaluation. P-VEP test was performed in all. Amplitude and latencies were analyzed and compared among groups. The latencies of P100 waves in the amblyopic eyes were used to generate a multiple linear regression formula from sex, ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Results:hTere was no signiifcant difference in the mean levels of best-corrected visual acuity among groups (P>0.05). A signiifcant prolongation of the latency and a decrease of amplitude of P100 waves were observed in the unilateral amblyopia group and the bilateral amblyopia group compared with the healthy control group (P<0.05). Amplitude and latencies of the fellow eyes in the unilateral amblyopia group were abnormal compared with the healthy control group (P<0.05). Multiple linear regression analysis revealed that the latencies of P100 waves were signiifcantly correlated with the ifrst treatment age, baseline visual acuity, and cycloplegic refraction (R2=0.52, P<0.05). Conclusion:Deifcits exist in the fellow eyes and in normal-vision eyes atfer pleoptic therapy. hTe delayed P100 latency is affected by the ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Traditional amblyopic therapy may be not enough for vision function recovery.