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Flicker electroretinogram in newborn infants.

James V M Hanson1, Caroline Weber2, Oliver A Pfäffli3

  • 1Department of Ophthalmology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Documenta Ophthalmologica. Advances in Ophthalmology
|October 5, 2022
PubMed
Summary

A new flicker electroretinogram (ERG) protocol is feasible for assessing retinal function in sleeping neonates. This method reliably records ERG through closed eyelids, offering a potential tool for monitoring infants at risk of retinopathy of prematurity.

Keywords:
ElectroretinogramFlicker ERGHuman neonateNewborn infantRetinal development

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Area of Science:

  • Ophthalmology
  • Neonatology
  • Electrophysiology

Background:

  • Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
  • Early detection and monitoring of ROP are crucial for timely intervention.
  • Assessing retinal function in neonates, especially preterm infants, presents unique challenges.

Purpose of the Study:

  • To develop and validate a flicker electroretinogram (ERG) protocol for term-born neonates.
  • To establish a non-invasive method for assessing retinal function in infants.
  • To create a potential tool for identifying preterm infants at risk of ROP.

Main Methods:

  • A custom flicker ERG protocol was developed using the RETeval® device and disposable skin electrodes.
  • Recordings were performed on sleeping, term-born neonates through closed eyelids without mydriasis.
  • Flicker stimuli of varying luminance were presented, and ERG peak times and amplitudes were analyzed.

Main Results:

  • The flicker ERG protocol was successfully implemented in 28 term-born neonates.
  • Testing was well-tolerated, and reproducible ERG waveforms were obtained, especially at higher stimulus strengths.
  • ERG amplitudes increased with stimulus strength, and peak times decreased, demonstrating a reliable response.

Conclusions:

  • Flicker ERG recording is feasible and reliable in sleeping neonates using a non-invasive, closed-eyelid approach.
  • The protocol demonstrates sensitivity to varying luminance levels, with detectable responses even at low stimuli.
  • This validated protocol provides a foundation for studying retinal function in preterm infants and assessing ROP risk.