Development of the electroretinogram between 30 and 50 weeks after conception

Flicker electroretinogram in preterm infants

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.

The Use of the RETeval Portable Electroretinography Device for Low-Cost Screening: A Mini-Review

Electroretinography (ERG) provides crucial insights into retinal function and the integrity of the visual pathways. However, ERG assessments classically require a complicated technical background with costly equipment. In addition, the placement of corneal or conjunctival electrodes is not always tolerated by the patients, which restricts the measurement for pediatric evaluations. In this short review, we give an overview of the use of the RETeval portable ERG device (LKC Technologies, Inc., Gaithersburg, MD, USA), a modern portable ERG device that can facilitate screening for diseases involving the retina and the optic nerve. We also review its potential to provide ocular biomarkers in systemic pathologies, such as Alzheimer's disease and central nervous system alterations, within the framework of oculomics.

Flicker electroretinogram in newborn infants

PURPOSE

To develop and validate a flicker electroretinogram (ERG) protocol in term-born neonates as a potential tool for assessing preterm infants at risk of developing retinopathy of prematurity.

METHODS

A custom flicker ERG protocol was developed for use with the hand-held RETeval® electrophysiology device. Feasibility of measuring flicker ERG through closed eyelids and without mydriasis was established in a pilot study enabling optimisation of the test protocol. Following this, healthy term-born neonates (gestational age 37-42 weeks) were recruited at the Neonatology clinic of the University Hospital Zurich. Flicker ERG recordings were performed using proprietary disposable skin electrodes during the first four days of life when the infants were sleeping. Flicker stimuli were presented at 28.3 Hz for a stimulus series at 3, 6, 12, 30, and 50 cd·s/m², with two measurements at each stimulus level. Results were analysed offline. Flicker ERG peak times and amplitudes were derived from the averaged measurements per stimulus level for each subject.

RESULTS

28 term-born neonates were included in the analysis. All infants tolerated the testing procedure well. Flicker ERG recording was achieved in all subjects with reproducible flicker ERG waveforms for 30 and 50 cd·s/m² stimuli. Reproducible ERGs were recorded in the majority of infants for the weaker stimuli (with detectable ERGs in 20/28, 25/28, and 27/28 at 3, 6, and 12 cd·s/m², respectively). Flicker ERG amplitudes increased with increasing stimulus strength, with peak times concurrently decreasing slightly.

CONCLUSION

Flicker ERG recording is feasible and reliably recorded in sleeping neonates through closed eyelids using skin electrodes and without mydriasis. Flicker ERG amplitude decreases for lower luminance flicker but remains detectable for 3 cd·s/m² flicker in the majority of healthy term-born neonates. These data provide a basis to study retinal function in premature infants using this protocol.

Dopamine D1 receptors regulate the light dependent development of retinal synaptic responses

Retinal synaptic connections and function are developmentally regulated. Retinal synaptic activity plays critical roles in the development of retinal synaptic circuitry. Dopamine receptors have been thought to play important roles in the activity-dependent synaptic plasticity in central nervous system. The primary goal of this study is to determine whether dopamine D1 receptor regulates the activity-dependent development of retinal light responsiveness. Accordingly, we recorded electroretinogram from wild type mice and mice with genetic deletion of D1 dopamine receptor (D1-/- mice) raised under cyclic light conditions and constant darkness. Our results demonstrated that D1-/- mice have reduced amplitudes of all three major components of electroretinogram in adulthood. When the relative strength of the responses is considered, the D1-/- mice have selective reduction of the amplitudes of a-wave and oscillatory potentials evoked by low-intermediate intensities of lights. During postnatal development, D1-/- mice have increased amplitude of b-wave at the time of eye-opening but reduced developmental increase of the amplitude of b-wave after eye opening. Light deprivation from birth significantly reduced the amplitudes of b-wave and oscillatory potentials, increased the outer retinal light response gain and altered the light response kinetics of both a- and b-waves of wild type mice. In D1-/- mice, the effect of dark rearing on the amplitude of oscillatory potentials was diminished and dark rearing induced effects on the response gain of outer retina and the kinetics of a-wave were reversed. These results demonstrated roles of dopamine D1 receptor in the activity-dependent functional development of mouse retina.

Light evokes melanopsin-dependent vocalization and neural activation associated with aversive experience in neonatal mice

Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) are the only functional photoreceptive cells in the eye of newborn mice. Through postnatal day 9, in the absence of functional rods and cones, these ipRGCs mediate a robust avoidance behavior to a light source, termed negative phototaxis. To determine whether this behavior is associated with an aversive experience in neonatal mice, we characterized light-induced vocalizations and patterns of neuronal activation in regions of the brain involved in the processing of aversive and painful stimuli. Light evoked distinct melanopsin-dependent ultrasonic vocalizations identical to those emitted under stressful conditions, such as isolation from the litter. In contrast, light did not evoke the broad-spectrum calls elicited by acute mechanical pain. Using markers of neuronal activation, we found that light induced the immediate-early gene product Fos in the posterior thalamus, a brain region associated with the enhancement of responses to mechanical stimulation of the dura by light, and thought to be the basis for migrainous photophobia. Additionally, light induced the phosphorylation of extracellular-related kinase (pERK) in neurons of the central amygdala, an intracellular signal associated with the processing of the aversive aspects of pain. However, light did not activate Fos expression in the spinal trigeminal nucleus caudalis, the primary receptive field for painful stimulation to the head. We conclude that these light-evoked vocalizations and the distinct pattern of brain activation in neonatal mice are consistent with a melanopsin-dependent neural pathway involved in processing light as an aversive but not acutely painful stimulus.

Desenvolvimento do olhar e do contato ocular em lactentes de zero a quatro meses de idade

OBJETIVOS: investigar o desenvolvimento do contato ocular e do comportamento visual de bebês entre zero e quatro meses. MÉTODOS: dezessete bebês típicos foram filmados mensalmente por 30 minutos, sendo transcritas 11 categorias de observação do olhar, quantificadas e tratadas estatisticamente através dos testes de Friedman (α = 0,050) e dos Postos Sinalizados de Wilcoxon (α de Bonferroni = 0,010). RESULTADOS: houve diferenças estatisticamente significantes nas frequências das categorias: "olhar para os olhos da mãe" (p<0,001), "olhar para o rosto da mãe" (p<0,001), "olhar para objeto" (p<0,001), "olhar para a pesquisadora" (p<0,001), "olhar para o ambiente de forma ativa" (p<0,001), "olhar para o ambiente de forma passiva" (p<0,001), "olhar para o próprio corpo" (p=0,001) e "olhos fechados" (p=0,005). Detectou-se o contato ocular na terceira semana de vida (64,7%) e comprovou-se sua evolução nos cinco primeiros meses (p=0,010 em 50% dos intervalos entre coletas). CONCLUSÕES: o contato ocular pode ser detectado desde o período neonatal e se desenvolve nos primeiros meses de vida. A frequência do contato ocular do bebê com sua mãe aumenta longitudinal-mente nos primeiros quatro meses. Existem outros focos de olhar do bebê fundamentais no início do desenvolvimento extrauterino além dos olhos de sua mãe.

Maturation of rod function in preterm infants with and without retinopathy of prematurity

OBJECTIVES

To establish normal development of rod electroretinograms in preterm infants and to assess the effects of retinopathy of prematurity (ROP).

STUDY DESIGN

We measured 88 Naka-Rushton functions from 41 preterm infants at maturities from 30 to 72 weeks postmenstrual age (PMA). Outcomes (log sigma, retinal sensitivity and V(max), retinal responsivity) were compared between control (no ROP), untreated ROP, and treated ROP.

RESULTS

In control infants, sensitivity increased by 1.5 log units from 30 to 40 weeks PMA and by a further 0.5 log units by 50 weeks PMA but was 0.5 log units less than in similarly-mature, healthy, term-born infants. Average retinal responsivity increased from 23 microV to 90 microV between 30 and 40 weeks PMA and was 35 muV greater at 40 weeks PMA than in similarly-mature term-born infants. At around 36 weeks PMA, (when onset of ROP peaks), infants with untreated ROP had average retinal sensitivity 0.2 log units lower than control infants; sensitivity was reduced further in infants treated for ROP. Retinal responsiveness did not differ between control subjects and untreated infants with ROP but was greatly reduced in infants treated for ROP.

CONCLUSIONS

Maturation of rod sensitivity appears to be slowed by preterm birth whereas maturation of rod responsivity is accelerated. ROP reduces retinal sensitivity, and treated ROP reduces both sensitivity and responsivity.

Structural and functional maturation of the retina of the albino Hartley guinea pig

PURPOSE

Altricial animals, such as rats and mice, are born with their eyes closed, compared to precocial animals, such as guinea pigs and humans, which have their eyes opened at birth. The purpose of this study was to investigate if the retina of guinea pigs (precocial animal) is subjected to a postnatal maturation process similar to that previously reported for rodents.

METHODS

Photopic and scotopic electroretinograms (ERG) and retinal histology were obtained from albino guinea pigs aged P1 to P75.

RESULTS

Photopic ERG responses reached maximal amplitudes at P5 (a-and b-waves), that is 5 days (b-wave) to 10 days (a-wave) earlier than scotopic responses. However, the postnatal gain in b-wave amplitude was significantly (P < 0.05) more important for the cone (73.38 +/- 4.4%) signal than for the rod (15.23 +/- 3.96%), suggesting that the rod function is more mature at birth. Similarly, the short latency photopic oscillatory potential (ie: OP2) reached its maximal value 5 days (P10) earlier than its scotopic equivalent (P15), while the long latency OPs (ie: OP3, OP4), reached their maximal values nearly 20 days sooner in scotopic condition. Finally retinal histology revealed a thinning of the retina with age, the latter being most pronounced at the level of the ganglion cell layer (GCL).

CONCLUSION

Our results thus confirm that despite its relative maturity at birth (compared to rodents), the retina of newborn albino guinea pigs undergoes significant postnatal maturation modifying its structure as well as its function, albeit not as extensive as that previously documented for altricial animals.