Dotto Patrícia de Freitas, Berezovsky Adriana, Sacai Paula Yuri, Rocha Daniel Martins, Salomão Solange Rios
Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo-UNIFESP, R. Botucatu 821, São Paulo, SP, 04023-062, Brazil.
Doc Ophthalmol. 2017 Aug;135(1):53-67. doi: 10.1007/s10633-017-9594-x. Epub 2017 May 30.
To determine gender-based normative values for pattern-reversal (PR) and flash (F) visually evoked potentials (VEP) under binocular and monocular stimulation in healthy adults.
Healthy adults (age ≥18 years) were recruited among university employees and students. Inclusion criteria were absence of abnormalities in fundoscopy, tracking ability, stereopsis and pupillary reflexes; best-corrected visual acuity ≤.00 logMAR; and refractive error (spherical equivalent) from -6.00 to +6.00. Exclusion criteria were previous intraocular surgery, systemic and/or neurological disorders. Binocular and monocular tests were performed according to International Society for Clinical Electrophysiology of Vision standards for PRVEP (reversal rate = 1.9 Hz, checkerboard stimuli 15' and 60' at 100% contrast) and FVEP (3 cd s/m, rate = 1 Hz). VEP parameters of amplitude (µV) and peak times (ms) were measured. Inter-ocular differences, inter-peak intervals (N135-N75) and binocular summation were determined.
Fifty-four subjects (28 females; mean age = 40.4 ± 13.7 years; median = 40.0 years) were included. Mean P100 latencies for 15' and 60' stimuli were, respectively, 94.6 ± 4.7 ms and 96.1 ± 4.2 for women. Mean values of P100 latency for men were 97.4 ± 4.9 for 15' and 97.7 ± 4.2 for 60' stimuli. Larger mean P100 for 15' checks was observed in women (12.8 ± 5.7 µV) than men (8.6 ± 2.5 µV) in PRVEP. Similar results were found for FVEP N2-P2 amplitudes (mean = 14.6 ± 4.9 for women and 9.8 ± 4.0 for men).
Gender-based normative values for PRVEP and FVEP were determined, with women disclosing higher responses than men for smaller stimuli in the visual pathway. The use of gender-based normative values in the analysis of clinical VEP data for diagnostic and therapeutic purposes is recommendable. Additional analysis including inter-peak intervals and binocular summation ratio might improve the diagnostic power of VEP.
确定健康成年人在双眼和单眼刺激下模式翻转（PR）和闪光（F）视觉诱发电位（VEP）基于性别的标准值。
在大学教职工和学生中招募健康成年人（年龄≥18岁）。纳入标准为眼底检查、跟踪能力、立体视觉和瞳孔反射无异常；最佳矫正视力≤.00 logMAR；屈光不正（等效球镜）为-6.00至+6.00。排除标准为既往有眼内手术史、全身性和/或神经系统疾病。根据国际临床视觉电生理学会的标准，对PRVEP（翻转频率=1.9 Hz，棋盘格刺激，对比度100%，视角15'和60'）和FVEP（3 cd s/m，频率=1 Hz）进行双眼和单眼测试。测量VEP的振幅（µV）和峰时（ms）参数。确定两眼间差异、峰间间期（N135-N75）和双眼总和。
纳入54名受试者（28名女性；平均年龄=40.4±13.7岁；中位数=40.0岁）。女性15'和60'刺激的平均P100潜伏期分别为94.6±4.7 ms和96.1±4.2 ms。男性15'和60'刺激的P100潜伏期平均值分别为97.4±4.9和97.7±4.2。在PRVEP中，女性15'方格的平均P100波幅（12.8±5.7 µV）大于男性（8.6±2.5 µV）。FVEP的N2-P2波幅也有类似结果（女性平均=14.6±4.9，男性平均=9.8±4.0）。
确定了PRVEP和FVEP基于性别的标准值，女性在视觉通路中对较小刺激的反应高于男性。建议在分析临床VEP数据以用于诊断和治疗目的时使用基于性别的标准值。包括峰间间期和双眼总和比的额外分析可能会提高VEP的诊断能力。
