Characteristics of Visual Evoked Potential in Different Parts of Visual Impairment

doi:10.12116/j.issn.1004-5619.2020.201004

Abstract

Abstract: Objective

To study the quantitative and qualitative differences of visual evoked potential （VEP） in monocular visual impairment after different parts of visual pathway injury.

Methods

A total of 91 subjects with monocular visual impairment caused by trauma were selected and divided into intraocular refractive media-injury group （eyeball injury group for short）, optic nerve injury group, central nervous system injury and intracranial combined injury group according to the injury cause and anatomical segment. Pattern Reversal visual evoked potential （PR-VEP） P100 peak time and amplitude, Flash visual evoked potential （F-VEP） P2 peak time and amplitude were recorded respectively. SPSS 26.0 software was used to analyze the differences of quantitative （peak time and amplitude） and qualitative indexes （spatial frequency sweep-VEP acuity threshold, and abnormal waveform category and frequency） of the four groups.

Results

Compared with healthy eyes, the PR-VEP P100 waveforms of the intraocular eyeball injury group and the F-VEP P2 waveforms of the optic nerve group showed significant differences in prolonged peak time and decreased amplitude in injured eyes （P<0.05）. The PR-VEP amplitudes of healthy eyes were lower than those of injured eyes at multiple spatial frequencies in central nervous system injury group and intracranial combined injury group （P<0.05）.The amplitude of PR-VEP in patients with visual impairment involving central injury was lower than that in patients with eye injury at multiple spatial frequencies. The frequency of VEP P waveforms reaching the threshold of the intraocular injury group and the optic nerve injury group were siginificantly different from the intracranial combined injury group, respectively（P<0.008 3）, and the frequency of abnormal reduction of VEP amplitude of threshold were significantly different from the central nervous system injury group, respectively（P<0.008 3）.

Conclusion

VEP can distinguish central injury from peripheral injury, eyeball injury from nerve injury in peripheral injury, but cannot distinguish simple intracranial injury from complex injury, which provides basic data and basis for further research on the location of visual impairment injury.

Key words: forensic medicine, eyeball injury, optic nerve injury, cortex injury, intracranial combined injury, visual dysfunction, visual evoked potential

CLC Number:

DF795.1

Ding-kun DAI, Li YANG, Huan-huan MENG, Xi-ping CHEN, Lu-yang TAO. Characteristics of Visual Evoked Potential in Different Parts of Visual Impairment[J]. Journal of Forensic Medicine, 2021, 37(5): 632-638.

Figures/Tables 5

Tab. 1 Information of subjects in different injury groups

组别	性别/例		眼数	年龄/（ $x ˉ$ ±s，岁）	伤眼主观视力
组别	男性	女性	眼数	年龄/（ $x ˉ$ ±s，岁）	最小值	最大值
眼球损伤	28	4	32	41 $±$ 14	HM	0.5
视神经损伤	22	1	23	39 $±$ 12	NLP	0.3
中枢脑损伤	12	6	18	46 $±$ 17	NLP	0.3
颅内合并损伤	14	4	18	46 $±$ 13	NLP	0.1

Tab. 1 Information of subjects in different injury groups

组别	性别/例		眼数	年龄/（ $x ˉ$ ±s，岁）	伤眼主观视力
组别	男性	女性	眼数	年龄/（ $x ˉ$ ±s，岁）	最小值	最大值
眼球损伤	28	4	32	41 $±$ 14	HM	0.5
视神经损伤	22	1	23	39 $±$ 12	NLP	0.3
中枢脑损伤	12	6	18	46 $±$ 17	NLP	0.3
颅内合并损伤	14	4	18	46 $±$ 13	NLP	0.1

Tab. 2 Latencies of F-VEP P2 and PR-VEP P100 waves of subjects in different groups （xˉ±s，ms）

组别	眼别	n	F-VEP P2	PR-VEP P100
组别	眼别	n	F-VEP P2	3°	1.5°	45′	23′	11′
眼球损伤	健眼	32	96.58±12.87	103.93±8.51	104.33±8.32	104.64±7.15	109.21±8.76	116.73±9.01
	伤眼	32	97.33±10.51	109.76±13.26^1）	109.49±12.81^1）	110.73±11.53^1）	116.24±13.07^1）	119.99±19.20
视神经损伤	健眼	23	96.18±8.74	107.65±8.38	108.17±7.38	107.18±7.53	109.42±5.62	114.53±10.51
	伤眼	23	100.86±7.76^1）	107.59±13.81	111.12±15.66	110.27±15.62	108.12±11.09	118.28±16.16
中枢脑损伤	健眼	18	102.73±9.56	100.85±10.38	104.42±8.60	109.42±6.95	115.01±8.46	118.46±7.87
	伤眼	18	106.44±12.62	102.91±8.45	109.42±8.32	-	-	-
颅内合并损伤	健眼	18	103.67±10.73	109.01±12.98	109.44±11.82	111.58±11.80	113.2±14.7	120.27±12.45
	伤眼	18	101.52±7.26	113.97±10.96	-	-	-	-

Tab. 3 Amplitudes of F-VEP P2 and PR-VEP P100 waves of subjects in different groups

组别	眼别	n	F-VEP P2	PR-VEP P100
组别	眼别	n	F-VEP P2	3°	1.5°	45′	23′	11′
眼球损伤	健眼	32	3.89±1.61	3.27±1.56	4.32±2.44	5.04±3.13	4.56±3.02	3.95±2.67
	伤眼	32	2.80±1.80	2.26±2.80^1）	2.79±3.23^1）	2.54±3.25^1）	2.21±3.50^1）	1.63±1.60^2）
视神经损伤	健眼	23	3.53±1.11	2.53±1.10	3.26±1.11	3.30±1.53	3.43±1.70	3.16±1.88
	伤眼	23	1.51±1.16^1）	1.71±1.44	1.47±1.06^1）	1.75±1.95^1）	2.23±2.20	1.92±2.34
中枢脑损伤	健眼	18	3.22±1.72	1.95±1.39^2）	2.36±1.88^2）	2.96±2.53^2）	3.02±2.57^2）	1.68±1.33^3）
	伤眼	18	1.53±1.00^1）	1.00±0.85^1）	1.63±1.33^1）	-	-	-
颅内合并损伤	健眼	18	3.58±1.99	1.88±1.39^2）	2.42±1.78^2）	2.12±1.49^2）	1.92±1.26	2.03±1.48
	伤眼	18	1.54±1.48^1）	0.83±0.74^1）3）	-	-	-	-

Tab. 4 Frequency of VEP P wave reaching threshold in injured eyes of each group

组别	n	频数
组别	n	F-VEP P2	PR-VEP P100	合计
眼球损伤	32	6	26	32
视神经损伤	23	5	13	18
中枢脑损伤	18	6	7	13^1）
颅内合并损伤	18	4	2	6^1）2）

Tab. 5 The difference of P waveform between two eyes at the threshold level of injured eyes in each group

组别	n	P波异常	波幅异常（降低30%）	峰时延长10 ms	波幅及峰时均存在异常
眼球损伤	32	30	28^1）	13	11
视神经损伤	18	16	16^1）	9	9
中枢脑损伤	13	13	7	6	4
颅内合并损伤	6	6	6	0	0

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