Balachandran C, Klistorner A I, Billson F
Save Sight Institute, Department of Ophthalmology, University of Sydney, Macquarie Street, PO Box 1614, Sydney 2001, Australia.
Br J Ophthalmol. 2004 Feb;88(2):226-32. doi: 10.1136/bjo.2003.018390.
To study the maturation of multifocal visual evoked potentials (multifocal VEP) in normal children between the ages of 5 and 16 years and to apply the results clinically in selected cases to the diagnosis of optic pathway diseases.
70 normal children were recruited from the community and multifocal VEP (Accumap ObjectiVision, Sydney, Australia) was recorded. The waveform of the evoked responses, the latency and amplitude were analysed. Using these data, an age matched comparison was made with three children with advanced optic nerve disease; two had optic nerve glioma and one had congenital glaucoma.
The full field amplitude did not correlate with age and varied greatly within each age group (coefficient of variability 28%). When scaled with respect to the background electroencephalogram the intra-age group variability decreased to 15% and a sigmoid relation was found between amplitude and age. The scaled amplitude remained largely unchanged till 11 years, between 11 and 13 years there was a rapid increase (40%), and remained stable thereafter. This relation was seen at all eccentricities tested. The latency decreased gradually with age and plateaued at 13 years. In the three children with vision abnormalities this test was able to detect scotomas consistent with their condition.
Multifocal VEP perimetry shows an age related maturation in the visual pathway, characterised by distinctive timeframe of development for amplitude and latency. It can be performed by children as young as 5 years of age and holds promise as a diagnostic test capable of documenting children's visual fields objectively, even before they are able to perform subjective field tests.
研究5至16岁正常儿童多焦视觉诱发电位（multifocal VEP）的成熟情况，并将结果临床应用于某些病例以诊断视路疾病。
从社区招募70名正常儿童，记录多焦VEP（Accumap ObjectiVision，澳大利亚悉尼）。分析诱发反应的波形、潜伏期和振幅。利用这些数据，与三名患有晚期视神经疾病的儿童进行年龄匹配比较；两名患有视神经胶质瘤，一名患有先天性青光眼。
全视野振幅与年龄无关，且在每个年龄组内差异很大（变异系数28%）。相对于背景脑电图进行缩放后，年龄组内变异降至15%，且发现振幅与年龄之间呈S形关系。缩放后的振幅在11岁之前基本保持不变，在11至13岁之间迅速增加（40%），此后保持稳定。在所有测试的离心度下均可见这种关系。潜伏期随年龄逐渐降低，并在13岁时趋于平稳。在三名视力异常的儿童中，该测试能够检测到与他们病情相符的暗点。
多焦VEP视野检查显示视路存在与年龄相关的成熟过程，其特征为振幅和潜伏期有独特的发育时间框架。该检查可由5岁的儿童进行，有望作为一种诊断测试，能够在儿童能够进行主观视野测试之前客观记录其视野情况。
