法医学杂志

法医学杂志 ›› 2024, Vol. 40 ›› Issue (5): 447-453.DOI: 10.12116/j.issn.1004-5619.2023.230407

• 论著 • 上一篇    下一篇

应用图形视觉诱发电位推断不同程度眼外伤愈后视力

郝虹霞1(), 陈捷敏1, 俞晓英1, 王萌1, 周智露1,2, 盛延良3(), 夏文涛1()   

  1. 1.司法鉴定科学研究院 上海市法医学重点实验室 司法部司法鉴定重点实验室 上海市司法鉴定专业技术服务平台，上海 200063
    2.贵州医科大学法医学院，贵州 贵阳 550009
    3.佳木斯大学基础医学院 微生态-免疫调节网络与相关疾病重点实验室，黑龙江 佳木斯 154007
  • 收稿日期:2023-04-20 发布日期:2025-02-11 出版日期:2024-10-25
  • 通讯作者: 盛延良,夏文涛
  • 作者简介:郝虹霞（1996—），女，硕士，主要从事法医临床学与视觉功能客观评定研究；E-mail：Haohongxia_HHX@163.com
  • 基金资助:
    国家重点研发计划资助项目(2022YFC3302001);上海市科技成果转化和产业化项目(19441914500);上海市法医学重点实验室资助项目(21DZ2270800);司法部司法鉴定重点实验室资助项目;上海市司法鉴定专业技术服务平台资助项目

Estimation of Visual Acuity after Recovery from Different Degrees of Ocular Trauma Using Pattern Visual Evoked Potential

Hong-xia HAO1(), Jie-min CHEN1, Xiao-ying YU1, Meng WANG1, Zhi-lu ZHOU1,2, Yan-liang SHENG3(), Wen-tao XIA1()   

  1. 1.Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
    2.Department of Forensic Medicine, Guizhou Medical University, Guiyang 550009, China
    3.Key Laboratory of Microecology-Immune Regulatory Network and Related Diseases, School of Basic Medicine, Jiamusi University, Jiamusi 154007, Heilongjiang Province, China
  • Received:2023-04-20 Online:2025-02-11 Published:2024-10-25
  • Contact: Yan-liang SHENG, Wen-tao XIA

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摘要：

目的 研究不同程度眼外伤的损伤类型与视觉诱发电位的特点，为复杂眼外伤的视力评估提供参考依据。 方法 选取眼外伤后致单眼视力损害者231例，根据眼外伤伤情的严重程度分为A组（无需行眼球开放性手术，伤情相对较轻）、B组（需行眼球开放性手术，对愈后视力可能造成一定影响）、C组（需多次行眼球开放性手术、行多联眼内手术或者术后需行进一步治疗，严重影响愈后视力） 3组。同时依据伤眼愈后最佳矫正视力进行分级：Ⅰ级，视力<4.0；Ⅱ级，4.0≤视力<4.5；Ⅲ级，4.5≤视力<4.7；Ⅳ级，视力≥4.7。分别收集研究对象伤眼视力平稳后的图形视觉诱发电位（pattern visual evoked potential，PVEP），记录在1°、15′空间频率刺激下P100波幅和峰时。评估不同眼外伤分组的视觉诱发电位特征与眼外伤程度的相关性，并对各组峰时、波幅异常的数据进行相关分析。 结果 C组在1°和15′空间频率刺激下测得的伤眼P100波幅与A、B组伤眼P100波幅之间差异具有统计学意义（P<0.05）。C组在15′空间频率刺激下测得的伤眼P100波幅异常数分别与A、B组相比差异均具有统计学意义（P<0.05）。Ⅰ、Ⅱ级中伤眼和健眼的P100波幅与同级别相比差异均具有统计学意义（P<0.05）。眼外伤分组与伤眼愈后视力分级之间存在相关性（P<0.05），相关系数r为-0.488。 结论 PVEP可用于区分A组与C组、B组与C组不同严重程度的眼外伤，在A、B组之间伤眼在1°和15′空间频率刺激下无法明确区分，眼外伤后伤眼P100波形的异常可为不同程度眼外伤被鉴定人的视觉评估提供一定的依据。

关键词: 法医学, 图形视觉诱发电位, 眼外伤, 视力, 视力分级

Abstract:

Objective To provide a reference for visual assessment in complex ocular trauma by studying the characteristics of visual evoked potential （VEP） in patients with different degrees of ocular trauma. Methods Based on the severity of ocular trauma, 231 patients with monocular visual impairment were selected and divided into groups A （no open surgery, relatively mild injury）, B （open surgery, which may have a certain impact on the visual acuity after recovery） and C （multiple open surgeries, multiple intraocular surgeries or further treatment after surgery, and serious impact on the visual acuity after recovery）. At the same time, according to the best corrected visual acuity （BCVA） after recovery, they were divided into four grades: Ⅰ, visual<4.0; Ⅱ, 4.0≤visual acuity<4.5; Ⅲ, 4.5≤visual acuity<4.7; Ⅳ, visual acuity≥4.7. The pattern visual evoked potential （PVEP） of these patients with stable visual acuity was collected, and the amplitude and peak time of P100 wave stimulated at 1° and 15′ spatial frequency were recorded. The correlations between the characteristics of VEP and the degree of ocular trauma in different groups were evaluated, and the data of abnormal peak time and amplitude in each group were analyzed. Results The P100 amplitude of injured eyes measured at 1° and 15′ spatial frequency in group C was significantly different from those in groups A and B （P<0.05）. The number of abnormal P100 amplitudes measured in group C under 15′ spatial frequency stimulation was statistically significant compared to groups A and B （P<0.05）. The P100 amplitudes of the injured and healthy eyes in grades Ⅰ and Ⅱ showed significant statistical differences （P<0.05）. There was a correlation （P<0.05） between the grouping of injured eyes and the visual acuity grading after recovery （r=-0.488）. Conclusion The PVEP can be used to distinguish between groups A and C, groups B and C with different degrees of eye trauma, but it cannot distinguish between group A and B at the 1° and 15′ spatial frequency stimulation. The abnormality of the P100 amplitudes after eye trauma can provide a certain basis for the visual evaluation of patients with different degrees of ocular trauma.

Key words: forensic medicine, pattern visual evoked potential, ocular trauma, visual acuity, vision grades

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