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Visual pathway function in adults born preterm with very low birth weight: a two-country birth cohort study

Anna P M Jørgensen1, Maarit Kulmala2,3, Dordi Austeng4,5

  • 1Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. anna.p.m.jorgensen@ntnu.no.

Documenta Ophthalmologica. Advances in Ophthalmology
|May 28, 2025
PubMed

Insights

Adults born preterm with very low birth weight (VLBW) showed subtle visual pathway differences, including delayed cortical responses and altered macular function. These electrophysiological changes did not impact best-corrected visual acuity (BCVA).

Area of Science:

  • Ophthalmology
  • Neuroscience
  • Developmental Biology

Background:

  • Preterm birth with very low birth weight (VLBW) is a significant risk factor for adverse neurodevelopmental outcomes.
  • Visual pathway development can be affected by prematurity and low birth weight, potentially leading to long-term functional deficits.
  • Understanding the long-term visual function in adults born VLBW is crucial for identifying potential health risks and guiding interventions.

Purpose of the Study:

  • To investigate the long-term effects of preterm birth with very low birth weight (VLBW) on macular and visual pathway function in adulthood.
  • To determine if best-corrected visual acuity (BCVA) is associated with electrophysiological responses in adults born VLBW.
  • To compare visual pathway function between adults born preterm with VLBW and term-born controls.

Main Methods:

  • Fifty adults born preterm with VLBW and 77 term-born controls (aged 31-41 years) were recruited from Finnish and Norwegian longitudinal studies.
  • Pattern reversal electroretinogram (PR-ERG) and visual evoked potential (PR-VEP) were performed to assess macular and visual pathway function.
  • Key electrophysiological components (e.g., P50, N95, N75, P100, N145) and BCVA were analyzed and compared between the VLBW and control groups.

Main Results:

  • Adults born preterm with VLBW exhibited a significantly longer N145 peak time (indicating delayed cortical processing) compared to controls.
  • The VLBW group also showed a lower N95:P50 amplitude ratio in the PR-ERG, suggesting potential alterations in macular function.
  • Despite these electrophysiological differences, BCVA was normal and similar in both groups, with no significant association found between electrophysiologic responses and BCVA.

Conclusions:

  • While primary visual cortex responses (N75, P100) were comparable, subtle electrophysiological deviations at higher cortical levels (N145) and in macular function (ganglion cell response) were observed in adults born preterm with VLBW.
  • These findings suggest that preterm birth with VLBW may lead to subclinical visual pathway alterations that do not manifest as reduced visual acuity in adulthood.
  • Further research is warranted to understand the clinical implications and potential long-term consequences of these subtle visual pathway differences.
Abstract

Keywords:
AdultPattern reversal electroretinogramPattern reversal visual evoked potentialPretermVery low birth weight

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