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目的比较斜视性弱视和屈光参差性弱视的机制的异同。方法采用视觉电生理诊断系统及1.5T 磁共振成像仪分别记录18例斜视性弱视和15例屈光参差性弱视患者的视觉诱发电位与血氧水平依赖功能磁共振成像信号。比较斜视性弱视和屈光参差性弱视患者的双眼像素指数及不同刺激条件下双眼大脑皮层神经元的平均活动水平,分析大脑皮层神经元的平均活动水平与 P_(100)波潜时的相关性。结果斜视性弱视患者的双眼像素指数较屈光参差性弱视患者明显减少(P<0.05)。选用任一空间频率(0.25、0.50、1.00、2.00c/d)刺激,屈光参差性弱视患者弱视眼驱使大脑皮层神经元平均活动水平均较对侧眼降低(P<0.05),斜视性弱视患者仅在高空间频率刺激时(1.00和2.00c/d),其弱视眼驱使大脑皮层神经元平均活动水平较对侧眼降低(P<0.01)。P_(100)波潜时与大脑皮层神经元平均活动水平呈负相关(P<0.05)。结论两种不同类型的弱视不仅双眼异常相互作用的程度不同,而且对视觉系统不同空间频率神经通路的损害亦不同。(中华眼科杂志,2006,42:873-877)
Objective To compare the similarities and differences between the mechanisms of amblyopia and strabismic amblyopia. Methods Visual evoked potentials and blood oxygen level-dependent fMRI signals were recorded in 18 patients with strabismic amblyopia and 15 patients with anisometropic amblyopia by visual electrophysiological diagnostic system and 1.5T magnetic resonance imaging system. Compared with binocular pixel index of patients with strabismic amblyopia and anisometropic amblyopia and average activity level of cerebral cortex neurons under different stimuli, the correlation between average activity level of cerebral cortex neurons and P_ (100) wave latency was analyzed . Results The binocular pixel index of patients with strabismic amblyopia was significantly lower than that of patients with anisometropic amblyopia (P <0.05). Amblyopic eyes with amblyopic eyes driven by either spatial frequency (0.25,0.50,1.00,2.00c / d) of amblyopic eyes drive cerebral cortex neurons average activity level compared with the contralateral eye decreased (P <0.05), strabismic amblyopia Only a high spatial frequency stimulation (1.00 and 2.00c / d), amblyopic eyes drive the average level of neurons in cerebral cortex decreased compared with the contralateral eye (P <0.01). The P_ (100) wave latency was negatively correlated with the average activity of neurons in cerebral cortex (P <0.05). Conclusion The two types of amblyopia not only have different degrees of anomalous interaction between eyes, but also have different damage to different spatial frequency neural pathways in the visual system. (Chinese Journal of Ophthalmology, 2006,42: 873-877)