The long-duration flash electroretinogram in children with retinopathy of prematurity

Purpose of the study was to determine the functional activity of the retina in children depending on both the degree of cicatricial retinopathy of prematurity (ROP) and the gestational age (GA) at birth based on the results of the long-duration flash electroretinogram (ERG) recording. Material and methods. A total of 31 patients (57 eyes) with ROP grades I–III aged 13.4 ± 2.7 years were examined, of which 13 children were born at ≤ 27 weeks GA. All children underwent recordings to a long-duration flash ERG. The amplitude and latency (peak time) of the a- and b-waves of the On-response and the d-wave of the Off-response were assessed. Results. When comparing ERG indices to a long-duration stimuli at different grades of ROP, a decrease in the amplitude of the a-, b- and d-waves of the On and Off ERG responses was noted compared to both the age norm and with an increase of ROP stage. When comparing the ERG parameters to a long-duration stimuli in children born at different gestational ages, a statistically significant difference was determined in the amplitude of the a-wave of the On-response and the d-wave of the Off-response between the control group and in children with GA ≤ 27 weeks and with GA > 27 weeks. Comparison of the temporal parameters of the analyzed ERG waves in the norm and in the eyes of children with GA ≤ 27 and GA > 27 weeks revealed statistically significant differences in the latency of the a-wave of the On-response (p < 0.01), while the latency of the b-wave of the On-response significantly differed only in the norm and GA > 27 weeks. Conclusion. A significant decrease in the amplitude of the a-wave of the On-response and the d-wave of the Off-response relative to the age norm in all eyes with ROP confirms the similarity of their generation from cone photoreceptors with the contribution of Off-bipolar cells and indicates their primary vulnerability early at stage I of ROP. Registration of ERG to a long-duration stimuli in children with ROP seems to be a sensitive and informative method for objective assessment of functional activity of the retina and may be used in combination with other types of ERG to allow more accurate determination of the degree and level of damage to the visual system in ROP.

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