Malessa R, Agelink M W, Diener H C
Department of Neurology, University of Essen, Germany.
J Neurol Sci. 1995 May;130(1):82-7. doi: 10.1016/0022-510x(95)00002-j.
Foveal and conventional full field pattern-shift visual evoked potentials (f-VEPs and c-VEPs) were recorded bilaterally in 100 HIV seropositive homosexual men (HIVs) and in 40 age-matched healthy controls. In HIVs, both f-VEPs and c-VEPs revealed a significant mean increase in P100 latency (p < 0.001). In stage WR2 early conduction changes were detected in 17% of the stimulated eyes by f-VEPs and in 3% by c-VEPs. In patients with CD4 cell counts below 100/microliters a 33% reduction in the mean c-VEP amplitude was found (ANOVA p < 0.01). Multivariate analyses (MANCOVA) revealed that CD4 cell depletion was independently associated with lower (p < 0.01) and zidovudine treatment with higher c-VEP amplitudes (p < 0.05). Also patients with severe CD4 cell depletion showed a trend towards higher c-VEP amplitudes (p = 0.09) and lower f-VEP latencies (p = 0.08) after long lasting zidovudine treatment (Kruskal-Wallis test). Our data suggest that f-VEPs are a sensitive measure of subclinical optic fiber dysfunction in early HIV-1 infection and that axonal loss of optic fibers emerges with manifest immune deficiency. The inverse correlation of VEP changes and zidovudine treatment merits further studies on the question, whether inhibition of HIV replication may preserve visual pathway function.
对100名HIV血清反应阳性的同性恋男性（HIV感染者）和40名年龄匹配的健康对照者双侧记录了中央凹和传统全视野模式翻转视觉诱发电位（f-VEPs和c-VEPs）。在HIV感染者中，f-VEPs和c-VEPs均显示P100潜伏期显著平均增加（p<0.001）。在WR2期，f-VEPs在17%的受刺激眼中检测到早期传导变化，c-VEPs在3%的受刺激眼中检测到早期传导变化。在CD4细胞计数低于100/微升的患者中，发现平均c-VEP波幅降低了33%（方差分析p<0.01）。多变量分析（MANCOVA）显示，CD4细胞耗竭与较低的c-VEP波幅独立相关（p<0.01），而齐多夫定治疗与较高的c-VEP波幅相关（p<0.05）。在长期接受齐多夫定治疗后，严重CD4细胞耗竭的患者也显示出c-VEP波幅升高（p=0.09）和f-VEP潜伏期降低（p=0.08）的趋势（Kruskal-Wallis检验）。我们的数据表明，f-VEPs是早期HIV-1感染中亚临床视神经纤维功能障碍的敏感指标，并且视神经纤维的轴突丢失随着明显的免疫缺陷而出现。VEP变化与齐多夫定治疗的负相关值得进一步研究HIV复制的抑制是否可能保留视觉通路功能这一问题。
