Weiss Avery H, Kelly J P
Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA, USA.
J AAPOS. 2003 Apr;7(2):108-15. doi: 10.1016/mpa.2003.S1091853102420046.
To determine whether Teller Acuity Cards, transient visually evoked potentials (VEPs), and optic disc size estimated from ophthalmoscopy were predictive of acuity outcome in infants and young children with bilateral optic nerve hypoplasia (ONH).
Twenty-eight infants (mean age, 7 months) with bilateral ONH underwent clinical assessment, including ophthalmoscopy. All but a few of these patients underwent neuroimaging studies, analysis of transient VEPs to multiple stimuli, and repeated acuity assessment. Acuity outcome was assessed, on average, 28 months later.
Acuity outcome was significantly correlated with the estimated optic disc diameter, initial acuity, and VEP signal-to-noise ratios (r = 0.80, 0.71, 0.69, respectively; all P <.001). Multiple regression analysis showed that the initial acuity and estimated optic disc diameter accounted for 73% of the variation in acuity outcome. VEPs to white-black gratings segregated infants by 6 months of age, whose acuity outcome was better or worse than 5.6 cycles/degree (20/100).
Acuity outcome was predicted in infants with bilateral ONH with a linear equation using initial acuity and estimated optic disc diameter. Additionally, analysis of VEPs may segregate infants with a good visual outcome from those with a poor visual outcome. Longer follow-up will be necessary to determine final Snellen acuity.
确定泰勒视力卡、瞬态视觉诱发电位（VEP）以及通过检眼镜估计的视盘大小是否可预测双侧视神经发育不全（ONH）婴幼儿的视力预后。
28例双侧ONH婴幼儿（平均年龄7个月）接受了包括检眼镜检查在内的临床评估。除少数患者外，所有患者均接受了神经影像学检查、对多种刺激的瞬态VEP分析以及多次视力评估。平均在28个月后评估视力预后。
视力预后与估计的视盘直径、初始视力以及VEP信噪比显著相关（r分别为0.80、0.71、0.69；均P<.001）。多元回归分析显示，初始视力和估计的视盘直径占视力预后变异的73%。对黑白光栅的VEP可将6个月大的婴幼儿区分开来，其视力预后优于或差于5.6周期/度（20/100）。
使用初始视力和估计的视盘直径，通过线性方程可预测双侧ONH婴幼儿的视力预后。此外，VEP分析可将视力预后良好的婴幼儿与视力预后较差的婴幼儿区分开来。需要更长时间的随访来确定最终的斯内伦视力。
