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目的对31例62眼急性甲醇(假酒)中毒者在各临床诊断分级中的自动视野的定量检查中发现的10种损害类型和图形视觉诱发电位(Pattern-VEP)P100波检查的改变与各诊断分级及中毒程度之间的关系进行探讨。方法参照中华人民共和国国家职业卫生标准GB253-2002和相关资料[1-2]、[穗卫函(2004201号)][1],对31例急性甲醇(假酒)中毒者,按上述标准分别诊断为观察病例11例22眼、轻度中毒9例18眼、重度中毒11例22眼,进行30°自动视野定量和P-VEPP100波潜伏期的检查。结果急性甲醇(假酒)中毒各临床诊断分级中,自动视野损害有10种类型,随中毒程度加深而不同。P-VEPP100潜伏期有延长和未引出两种改变。观察病例以生理盲点扩大(59%)、视敏度下降(54%)和旁中心暗点(18%)为主。轻度中毒以视敏度下降(100%)、生理盲点扩大(38%)、旁中心暗点(38%)为主。重度中毒以视敏度下降(100%)、象限缺损(18%)、向心性缩窄(18%)和广泛性缺损(13%)为主,P-VEPP100波潜伏期在观察病例中90%正常,轻度中毒78%正常,重度中毒100%异常。结论急性甲醇(假酒)中毒者自动视野和P-VEPP100波在临床诊断的不同分级中的表现类型和损害部位不同,随中毒程度加深而不同,可作为诊断分级标准中视功能损害的重要客观指标。急性甲醇中毒对眼部的损害,除视神经、视交叉及以上部位以外,还有视网膜,视细胞及神经纤维层的损害。
OBJECTIVE To investigate the changes of pattern of P100 wave in 10 types of lesions and pattern visual evoked potentials (Pattern-VEP) found in quantitative examination of 31 cases of 62 cases of acute methanol (fake alcohol) poisoning in clinical diagnosis grading with Diagnostic classification and the relationship between the degree of poisoning to explore. Methods Reference to the National Occupational Health Standard GB253-2002 of the People’s Republic of China and related information [1-2], [Sui Wei letter (2004201)] [1], 31 cases of acute methanol poisoning, according to the above criteria Diagnosed as observation of 11 cases in 22 cases, mild poisoning in 9 cases 18 eyes, severe poisoning in 11 cases 22 eyes, 30 ° automatic field quantification and P-VEPP100 wave latency examination. Results Acute methanol (fake alcohol) poisoning in the clinical diagnosis of grading, there are 10 types of automatic visual field damage, with the deepening of poisoning and different. P-VEPP100 latency has been extended and did not lead to two changes. The observed cases were mainly physical blind spot enlargement (59%), decreased visual acuity (54%) and paracentesis (18%). Mild poisoning with visual acuity decreased (100%), physiological blind spot expansion (38%), next to the center of dark spots (38%) dominated. Severe poisoning with visual acuity decreased (100%), quadrant defect (18%), concentric narrowing (18%) and extensive defects (13%) mainly P-VEPP100 wave latency observed in 90% of normal , Mild poisoning 78% normal, severe poisoning 100% abnormal. Conclusions The types of auto-field of vision and P-VEPP100 wave in different stages of clinical diagnosis of acute methanol (fake alcohol) poisoning are different and their location is different with the degree of poisoning deepening, which can be used as an important objective indicator of visual impairment in diagnostic grading standards . Acute methanol poisoning damage to the eye, in addition to the optic nerve, optic chiasm and above the site, there are retinal, depending on cells and nerve fiber layer damage.