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Flicker electroretinogram in preterm infants
Aylin F Taner1, James V M Hanson1, Caroline Weber2
1Department of Ophthalmology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Insights
This study found that flicker electroretinograms (ERGs) are feasible in preterm infants. Very preterm infants showed higher retinal amplitudes, suggesting accelerated development possibly due to visual stimulation.
Area of Science:
- Ophthalmology
- Neonatology
- Neuroscience
Background:
- Preterm infants are at risk for retinopathy of prematurity, impacting retinal function.
- Electroretinography (ERG) is used to measure retinal function abnormalities.
Purpose of the Study:
- To record non-invasive flicker ERGs in preterm infants.
- To compare retinal function between moderate and very/extremely preterm infants.
Main Methods:
- 40 moderate preterm and 40 very/extremely preterm infants underwent flicker ERG recording.
- The RETeval® device with skin electrodes was used for closed-eyelid recordings.
- Stimuli at 28.3 Hz and varying intensities (3-50 cd•s/m²) were presented; peak time and amplitude were primary endpoints.
Main Results:
- Flicker ERGs were recordable in most infants, with best reproducibility at 30 cd•s/m².
- ERG amplitudes increased with stimulus intensity.
- Significantly greater amplitudes were observed in very/extremely preterm infants at the highest stimulus level (p<0.001).
Conclusions:
- Collecting flicker ERG data in preterm infants is feasible.
- No evidence of reduced retinal responses was found in extremely preterm infants.
- Higher amplitudes in very/extremely preterm infants may indicate accelerated retinal development driven by visual input.
Background:
Infants born prematurely are at risk of developing retinopathy of prematurity, which is associated with abnormalities in retinal function as measured using electroretinography. The aim of this study was to record non-invasive flicker electroretinograms (ERGs) in preterm infants and compare function of moderate and very or extremely preterm infants.
Methods:
In this non-randomized, cross-sectional study, 40 moderate preterm (gestational age (GA) 34 0/7 to 36 6/7 weeks, Group A) and 40 very or extremely preterm infants (GA ≤ 31 weeks, Group B) were recruited for flicker ERG recording through closed eyelids using the RETeval® device and skin electrodes. Group A was tested within the first week of life and Group B between 34th and 37th week postmenstrual age. Flicker stimuli were presented at 28.3 Hz with stimulus levels of 3, 6, 12, 30 and 50 cd•s/m2. Primary endpoints were peak time (ms) and amplitude (µV).
Results:
Flicker ERGs were recordable in most infants with the highest proportion of reproducible ERGs at 30 cd•s/m2. Amplitudes increased with stronger flicker stimulation, while peak times did not differ significantly between stimulus levels nor groups. Amplitudes were significantly greater in Group B at the strongest stimulus level (Mann-Whitney-U-Test=198.00, Z = 4.097, p = <0.001).
Conclusions:
Feasibility of collecting flicker ERG data in most preterm infants was confirmed. We found no evidence of reduced retinal responses to flicker stimuli associated with extreme prematurity. Higher amplitudes in very and extremely preterm infants could indicate acceleration of retinal development following birth, triggered by visual stimulation.
