The significance of multifoac l visua l evok ed potential combined with opticalc oherence tomography in the di-agnosis of glaucoma

CHEN Li-fie; WEN Mei-dan; ZENG Si-mi ng

doi:10.3969/j.issn.1674-3806.2015.02.03

Abstract：Objce tive To explore the objectivity and sensitivity of multifocal visual evoked potential ( mfVEP) combined with optical coherence tomography( OCT)in the diagnosis of functional and structural change of glaucoma.Methods Ninety glaucoma patients( experimental group) and30 patients with normal eyesight( the control group) were taken Humphrey perimetry( HVF) , mfVEP and OCT examination.According to the extent of glaucoma-tous visual field damage,all glaucoma patients were divided into 3 subgroups:mild damage group, moderate damage group, severe damage group,with 30 cases in each group.One eye with lighter damage was selected for evaluating the sensitivity and objectivity of mfVEP and OCT.Results The average visual field defect ( mean deviation, MD) was (-0.93 ±0.97)dB in the control group, (-3.16 ±1.76)dB in mild injury group, (-12.82 ±3.92) dB in mod-erate damage group, (-27.10 ±3.73)dB in severe damage group.The extent of damage in each subgroup of the ex-perimental group was greater than that in the control group,showing a statistically significant difference; The average thickness of peripapillary retinal nerve fiber layer was (109.14 ±6.48)μm in the control group, (98.97 ±15.43)μm in the mild damage group, (72.63 ±11.21)μm in the moderate damage group, and (64.15 ±11.45)μm in the se-vere injury group, peripapillary RNFL thickness in each subgroup of experimental group was thinner than that in the control group,the difference was statistically significant, and RNFL thickness got more thinner with the increase of the extent of damage of glaucoma.The RMS of amplitude of mfVEP was ( 12.60 ±4.19 ) nV/deg2 in the control group, (11.23 ±6.36)nV/deg2 in the mild damage group, (10.38 ±4.95) nV/deg2 in the moderate damage group, and (8.03 ±3.89)nV/deg2 in the severe injury group, in all subgroups of experimental group,the difference between mild and moderate damage group and control group was not statistically significant, the difference between severe damage group and the control group was statistically significance.The average latent time of mfVEP was (104.37 ± 24.95)ms in the control group, (102.09 ±32.89)ms in the mild injury group,(99.73 ±7.83)ms in the moderate damage group, and (96.71 ±5.86)ms in the severe damage group, between each subgroup of experimental group, and the control group the difference was not statistically significant.Conclusion OCT can show the damage of the nerve fiber layer in patients with glaucoma objectively, mfVEP is more valuable for diagnosis of advanced glaucoma, and the RMS is more valuable than the average of latent time;mfVEP combined with OCT and HVF is more helpful in the diagnosis of glaucoma.