Einfluss der Makulareifung auf Ganzfeld- und multifokales ERG bei ehemaligen Extremfrühgeborenen mit und ohne akute Frühgeborenenretinopathie

Abstract

Retinal development is a complex process that can continue into early childhood and beyond. Prematurity can affect the maturation of the central retina, characterised by a flatter foveal pit and overlying inner retinal layers (IRL), leading to a disturbed ratio of outer retinal layers to IRL ("macular developmental arrest": MDA) and functional impairment (Bowl et al. 2016 18). The purpose of this study was to correlate functional results by electrophysiology with the morphological appearance of the fovea in children with spontaneously regressed and without ROP and term-born age-matched controls. We investigated n = 60 preterm-born children with spontaneously regressed (srROP, n = 15) and without ROP (noROP, n = 50) as part of an extensive prospective cohort study and compared them to n = 10 term-born age-matched controls (Term). Full-field electroretinogram (ffERG) and multifocal ERG (mfERG) based on ISCEV-standards were performed in every child for functional evaluation. Foveal morphology was evaluated with optical coherence tomography (SD-OCT, Spectralis, Heidelberg Engineering, Germany). Analysis of the scotopic ffERG showed significantly modified b-wave amplitudes in srROP and noROP, especially when MDA was found on SD-OCT. The mfERG exhibited a modified P1-component of the central hexagon and the second concentric ring in children with MDA. No other parameters were significantly changed. Electrophysiological changes can be found in extremely preterm-born children, especially with OCT-confirmed foveal maturation impairment (MDA), namely in children with spontaneously regressed ROP as well as in children without ROP. The reduced b-wave in the scotopic ffERG and the reduced P1-component in the mfERG indicate involvement of bipolar cells in extremely prematurely born children with MDA. In particular, the correlation of MDA with ffERG could be a sign of more global retinal maturation disturbance accompanying MDA, and this is seen even without acute ROP.

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