暗适应3.0振荡电位预测缺血型视网膜中央静脉阻塞的临床应用价值

Dark-adapted 3.0 oscillatory potentials in predicting ischemic central retinal vein occlusion

  • 摘要: 目的 暗适应3.0振荡电位预测缺血型视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)的临床价值。 方法 2010年6月- 2015年1月在延安市人民医院诊断为CRVO患者80例(80只眼),行视力、眼压、眼底及振荡电位、眼底荧光造影检查。随访2~9个月(平均6个月),发生缺血型CRVO为阳性组,未发生为阴性组。采用ROC曲线分析振荡电位在预测缺血型CRVO中的临床价值。 结果 振荡电位各子波的幅值及总幅值对于预测缺血型CRVO具有一定的临床价值,其中以振荡电位第2个子波(2nd wave of oscillatory potentials,OP2)和振荡电位总幅值的灵敏度及特异度最高。以OP2 = 18.1μV为截点值,预测缺血型CRVO的灵敏度96.7%,特异度93.3%,曲线下面积0.981 (P< 0.001,95% CI:0.897~1.000);以振荡电位总幅值= 64.9μV为截点值,预测缺血型CRVO的灵敏度96.7%,特异度90.0%,曲线下面积0.981 (P< 0.001,95% CI:0.903~1.000)。 结论 振荡电位幅值下降程度与视网膜微循环功能受损程度相关,是预测缺血型CRVO的敏感性指标。

     

    Abstract: Objective To evaluate the predictive value of dark-adapted 3.0 oscillatory potentials in predicting the onset of ischemia in central retinal vein occlusion (CRVO). Methods Eighty eyes of 80 patients who had been diagnosed with CRVO in Yan'an People's Hospital from June 2010 to January 2015 were recruited. All patients had undergone ophthalmological examination, including visual acuity, intraocular pressure, fundus examination, ERG testing and fluorescein angiography. Patients were followed up for 2 to 9 months (mean 6 months), and they were divided into negative group and positive group according to whether they developed ischemic CRVO or not. Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of amplitudes of oscillatory potentials (OPs) for ischemic CRVO. Results Certain wave and total amplitude of OPs could predict ischemic CRVO, and the sensitivity and specificity of 2nd wave of OPs (OP2) and total amplitude of OPs were the highest. Taking OP2=18.1μV as the cut-off point, the sensitivity was 96.7% and the specificity was 93.3% with the areas under the ROC curve of 0.981 (P< 0.001, 95% CI: 0.897-1.000). While, taking total amplitude of 64.9μV as the cut-off point, the sensitivity was 96.7% and the specificity was 90.0% with the areas under the ROC curve of 0.981 (P< 0.001, 95% CI: 0.903-1.000). Conclusion Decreased amplitudes of OPs are consistent with the degree of dysfunctional microcirculation in retina, which is a sensitive index in predicting ischemic CRVO.

     

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