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儿童造血异体干细胞移植后的视觉诱发电位

Visual evoked potentials after hematopoietic allogeneic stem cell transplantation in childhood.

作者信息

Törnquist Alba Lucia, Andersson Thomas, Winiarski Jacek, Grönlund Marita Andersson, Fahnehjelm Kristina Teär

机构信息

Department of Clinical Neuroscience, Karolinska Institutet and St Erik Eye Hospital, Polhemsgatan 50, SE 112 82 Stockholm, Sweden.

Department of Clinical Neurophysiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.

出版信息

Clin Neurophysiol Pract. 2017 Mar 2;2:67-71. doi: 10.1016/j.cnp.2017.02.001. eCollection 2017.

DOI:10.1016/j.cnp.2017.02.001
PMID:30214974
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6123843/
Abstract

OBJECTIVE

To study visual pathway pathology detected by visual evoked potentials (VEPs) in patients treated with hematopoietic stem cell transplantation (HSCT) in childhood and to determine the impact of adverse ocular findings, somatic diseases, and conditioning regimens on the VEP results.

METHODS

Ophthalmological assessments including pattern VEPs were performed in 47 of 79 patients at a median age of 15 years (range 3-21 years) in median 6 years (1-17 years) after HSCT. Somatic data were extracted from medical records.

RESULTS

Eight patients of 47 (17%) demonstrated pathological VEPs with prolonged latencies bilaterally (n = 3) or unilaterally (n = 5) at their latest VEP test at an age of 12-18 years. A subnormal visual acuity was present in 8/11 eyes with pathological VEPs: one eye had cataract, six eyes had cataract surgery where of two had developed secondary cataracts. One eye had residual retinopathy of prematurity. Pathological VEPs were associated with decreased visual acuity (p = 0.00019) but not linked to gender, malignant diagnosis or conditioning.

CONCLUSION

VEP recordings showed an association with decreased visual acuity but no relationship with irradiation or chemotherapy in the present study.

SIGNIFICANCE

VEP recordings might be of clinical value for children with an unexplained subnormal visual acuity undergoing HSCT.

摘要

目的

研究儿童造血干细胞移植(HSCT)患者视觉诱发电位(VEP)检测到的视觉通路病理情况,并确定眼部不良发现、躯体疾病和预处理方案对VEP结果的影响。

方法

对79例患者中的47例进行了眼科评估,包括图形VEP,这些患者的中位年龄为15岁(范围3 - 21岁),在HSCT后中位6年(1 - 17年)。从病历中提取躯体数据。

结果

47例患者中有8例(17%)在12 - 18岁的最近一次VEP测试中表现出病理性VEP,双侧潜伏期延长(n = 3)或单侧潜伏期延长(n = 5)。11只患有病理性VEP的眼睛中有8只视力低于正常:1只眼睛有白内障,6只眼睛进行了白内障手术,其中2只出现了继发性白内障。1只眼睛有早产儿视网膜病变残留。病理性VEP与视力下降相关(p = 0.00019),但与性别、恶性诊断或预处理无关。

结论

在本研究中,VEP记录显示与视力下降有关,但与放疗或化疗无关。

意义

对于接受HSCT且视力 unexplained低于正常的儿童,VEP记录可能具有临床价值。 (注:“unexplained”原文如此,可能有误,推测应为“unexplainedly”之类的词,但按要求未改动)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b3a/6123843/c79acc184430/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b3a/6123843/2246d1c6a7cd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b3a/6123843/c79acc184430/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b3a/6123843/2246d1c6a7cd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b3a/6123843/c79acc184430/gr2.jpg

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本文引用的文献

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2
Hematopoietic Stem Cell Transplantations for Primary Immune Deficiencies: 3 Decades of Experience From a Tertiary Medical Center.原发性免疫缺陷的造血干细胞移植:来自三级医疗中心的30年经验
J Pediatr Hematol Oncol. 2015 Jul;37(5):e295-300. doi: 10.1097/MPH.0000000000000352.
3
Ocular complications in children after hematopoietic stem cell transplantation without total body irradiation.
未接受全身照射的儿童造血干细胞移植后的眼部并发症
Graefes Arch Clin Exp Ophthalmol. 2015 Aug;253(8):1397-402. doi: 10.1007/s00417-015-2964-8. Epub 2015 Feb 24.
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Outcome of children with high-risk acute myeloid leukemia given autologous or allogeneic hematopoietic cell transplantation in the aieop AML-2002/01 study.在AIEOP AML - 2002/01研究中接受自体或异基因造血细胞移植的高危急性髓系白血病患儿的结局
Bone Marrow Transplant. 2015 Feb;50(2):181-8. doi: 10.1038/bmt.2014.246. Epub 2014 Nov 10.
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