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Updated: Mar 2, 2026
Multifocal Electroretinograms
Published on: December 4, 2011
Multifocal ERG Responses in Subjects With a History of Preterm Birth
Pablo Altschwager1, Anne Moskowitz2, Anne B Fulton2
1Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States 2Departamento de Oftalmologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Insights
Premature birth impacts cone-mediated retinal function, with effects worsening with retinopathy of prematurity (ROP) severity. Even without ROP, preterm birth alone can alter retinal circuitry.
Area of Science:
- Ophthalmology
- Neuroscience
- Developmental Biology
Background:
- Preterm birth is a significant risk factor for visual impairment in children.
- Retinopathy of prematurity (ROP) is a major cause of vision loss in premature infants, but visual function can also be affected by preterm birth itself.
- Cone-mediated retinal function is crucial for sharp, central vision and color perception.
Purpose of the Study:
- To assess cone-mediated central retinal function in children with a history of preterm birth.
- To compare retinal function in preterm children with and without retinopathy of prematurity (ROP).
- To evaluate the impact of ROP severity on retinal function.
Main Methods:
- Utilized multifocal electroretinogram (mfERG) to record postreceptor retinal activity.
- Recorded mfERG responses to a 103-element hexagonal array covering 43° of the central visual field.
- Analyzed N1 and P1 response amplitudes and latencies in six concentric rings, comparing preterm infants (severe ROP, mild ROP, no ROP) with term-born controls.
Main Results:
- Cone-mediated retinal function (N1 and P1 amplitudes) varied significantly with eccentricity and ROP severity.
- N1 amplitude was significantly reduced in severe ROP but similar across mild ROP, no ROP, and control groups.
- P1 amplitude was reduced in all preterm groups compared to controls, with the most significant reduction in severe ROP.
Conclusions:
- Preterm birth alone adversely affects cone-mediated central retinal function.
- The degree of visual impairment correlates with the severity of antecedent ROP.
- ROP's impact on the neurosensory retina may extend beyond visible vascular abnormalities.
Purpose:
The purpose of this study is to assess cone-mediated central retinal function in children with a history of preterm birth, including subjects with and without retinopathy of prematurity (ROP). The multifocal electroretinogram (mfERG) records activity of the postreceptor retinal circuitry.
Methods:
mfERG responses were recorded to an array of 103 hexagonal elements that subtended 43° around a central fixation target. The amplitude and latency of the first negative (N1) and first positive (P1) response were evaluated in six concentric rings centered on the fovea. Responses were recorded from 40 subjects with a history of preterm birth (severe ROP, mild ROP, no ROP) and 19 term-born control subjects.
Results:
The amplitude of N1 and P1 varied significantly with eccentricity and ROP severity. For all four groups, these amplitudes were largest in the center and decreased with eccentricity. At all eccentricities, N1 amplitude was significantly smaller in severe ROP and did not differ significantly among the other three groups (mild ROP, no ROP, term-born controls). P1 amplitude in all preterm groups was significantly smaller than in controls; P1 amplitude was similar in no ROP and mild ROP and significantly smaller in severe ROP.
Conclusions:
These results provide evidence that premature birth alone affects cone-mediated central retinal function and that the magnitude of the effect varies with severity of the antecedent ROP. The lack of difference in mfERG amplitude between the mild and no ROP groups is evidence that the effect of ROP on the neurosensory retina may not depend solely on appearance of abnormal retinal vasculature.
