【摘要】 目的 探究图像视觉诱发电位自律空间频率刺激疗法(PVEP-CD)联合视觉虚拟现实训练在重度弱视患儿中的治疗效果。方法 选取2020年6月至2024年7月就诊于焦作市妇幼保健院和河南省立眼科医院的286例(526眼)重度弱视患儿为研究对象，依据随机数字表分为对照组(143例，259眼)和观察组(143例，267眼)。对照组给予视觉虚拟现实训练，观察组基于对照组给予PVEP-CD治疗，两组均治疗6个月。对比两组疗效、双眼近立体视锐度分级、最佳矫正视力(BCVA)、中心凹厚度、副中心凹外核层厚度、P100潜伏期和振幅。结果 观察组患者的总有效率为96.63%(258/267)，明显高于对照组的89.58%(232/259)，差异有统计学意义(P<0.05)；治疗6个月后，两组患者的双眼近立体视锐度分级均优于治疗前，且观察组患者的双眼近立体视锐度分级优于对照组，差异有统计学意义(P<0.05)；治疗3个月、6个月后两组患者的LogMAR均低于治疗前，且观察组患者治疗3个月、6个月后的LogMAR分别为(0.72±0.10)、(0.62±0.07)，均低于对照组的(0.82±0.12)、(0.74±0.10)，差异均有统计学意义(P<0.05)；治疗6个月后两组患者的P100波潜伏期均低于治疗前，且观察组患者的P100波潜伏期为(105.85±9.08)ms，明显低于对照组的(110.45±10.41)ms;P100波振幅均高于治疗前，且观察组患者的P100波振幅为(14.95±3.23)μV，明显高于对照组的(13.37±3.01)μV，差异均有统计学意义(P<0.05)；治疗6个月后两组中心凹厚度、副中心凹外核层厚度高于治疗前，差异有统计学意义(P<0.05)，但组间比较，差异无统计学意义(P>0.05)。结论 PVEP-CD联合视觉虚拟现实训练治疗重度弱视患儿效果良好，可调节视觉信息传导及处理路径，增强双眼近立体视锐度，提高患儿视力水平。更多还原

【Abstract】 Objective To investigate the therapeutic effect of the combined treatment of pattern visual evoked potential-CD(PVEP-CD) and visual virtual reality training on children with severe amblyopia. Methods A total of 286 children(526 eyes) with severe amblyopia who were treated in Jiaozuo Maternal and Child Health Hospital and Henan Eye Hospital & Henan Eye Institute from June 2020 to July 2024 were selected as the research subjects.They were randomly divided into two groups using a random number table method,namely the control group(143 cases,259eyes) and the observation group(143 cases, 267 eyes). Patients in the control group were given visual virtual reality training,and those in the observation group were given PVEP-CD treatment plus visual virtual reality training.Patients in both groups were treated for 6 months.The efficacy,binocular near stereoscopic acuity grading,best corrected visual acuity(BCVA), foveal thickness, thickness of the outer nuclear layer of the parafovea, P100 latency, and amplitude were compared between the two groups. Results The total effective rate of patients in the observation group was significantly higher than that of the control group(96.63% [258/267] VS 89.58%[232/259], P<0.05). After 6 months of treatment,the binocular near stereopsis acuity grading of both groups was improved than the pre-treatment value,which was significantly better in the observation group than the control group(P<0.05).After 3 and 6 months of treatment,the LogMAR scores of both groups were reduced than pre-treatment values.The LogMAR scores after 3(0.72±0.10) VS(0.82±0.12) and 6 months of treatment(0.62±0.07) VS(0.74±0.10) were significantly lower in the observation group than the control group(both P<0.05).After 6 months of treatment,the latency of P100 wave in both groups was reduced than the pre-treatment value.It was significantly lower in the observation group than the control group(105.85±9.08)ms VS(110.45±10.41)ms,P<0.05.The amplitude of P100 wave was elevated after treatment than the pre-treatment value in both groups, which was significantly higher in the observation group than the control group(14.95±3.23)μV VS(13.37±3.01)μV(P<0.05).After 6 months of treatment,the thickness of the fovea centralis and the outer nuclear layer of the fovea paracentralis in both groups were elevated than the pre-treatment value(P<0.05). However, there was no significant difference between the groups(P>0.05). Conclusion The treatment of PVEP-CD combined with visual virtual reality training for children with severe amblyopia has good effects,which can adjust the transmission and processing path of visual information,enhance the binocular near stereoscopic acuity,and improve the vision level of children.更多还原