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目的分析视觉诱发电位(VEP)、视网膜电图(ERG)、振荡电位(OPS)在眼挫伤鉴定中的应用意义。方法应用眼电生理检查仪对98例无屈光间质病变的眼挫伤患者除行常规眼科检查外,分别行闪光-ERG(F-ERG)、图形-VEP(P-VEP)、闪光-VEP(F-VEP)、OPS检查。结果记录VEP的P100峰潜时和振幅,ERG的a、b波峰时和振幅,以及OPS峰时和振幅。其中22例(22.45%)VEP100波峰值及峰潜时无明显异常,F-ERGa、b波峰值无明显降低,OPS振幅值无明显下降,与对照组比较差异均无统计学意义(P均>0.05),后经证实为伪盲。76例(77.55%)F-VEP或P-VEPP100波峰潜时延长,波峰值明显降低,F-ERGa、b波明显下降,OPS振幅值下降,与对照组比较差异均有统计学意义(P均<0.01)。其中43例(56.58%)经治疗后视力均有所提高,其余33例(43.42%)合并不同程度的视网膜病变或视神经萎缩。结论眼电生理检查为医学鉴定提供了具有参考价值的客观依据,但在视力鉴定及伪盲鉴定中应谨慎。
Objective To analyze the significance of visual evoked potential (VEP), electroretinography (ERG) and oscillatory potential (OPS) in the identification of eye contusion. Methods Ninety-nine patients with contusion of the eye without refractive disease were examined with F-ERG, P-VEP, Flash-VEP (F-VEP), OPS examination. Results The VEP P100 peak latency and amplitude, ERG a, b peak time and amplitude, and OPS peak time and amplitude were recorded. The peak value of VEP100 in 22 cases (22.45%) and no significant abnormal peak latency, F-ERGa, b wave peak was no significant reduction, OPS amplitude no significant decline, compared with the control group, no significant difference (P> 0.05), later confirmed as false blindness. The peaks of F-VEP or P-VEPP100 in 76 cases (77.55%) were latent, the wave crest value was significantly decreased, the F-ERGa and b wave levels were significantly decreased, and the amplitude of OPS amplitude was decreased compared with the control group <0.01). Among them, 43 cases (56.58%) had improved visual acuity after treatment, and the remaining 33 cases (43.42%) had different degrees of retinopathy or optic atrophy. Conclusion The electrophysiological examination provides an objective basis for medical appraisal with reference value, but should be cautious in the appraisal of visual acuity and pseudopair.