Early Ametropia and Rod Photoreceptor Function in Retinopathy of Prematurity

Abstract

Early ametropia, particularly myopia, is frequent in children with a history of preterm birth and retinopathy of prematurity (ROP). The retina is known to govern eye growth and refractive development. We tested the hypothesis that deficits in retinal function are significantly associated with early ametropia in ROP subjects. Scotopic electoretinogram (ERG) responses to full field stimuli were studied in 40 ROP subjects aged 8 weeks to 18 years. The ROP was categorized as treated, untreated, or none. Refractive development of each ROP subject was monitored and compared with normal for age. The rod photoresponse parameters were calculated and the postreceptoral responses derived. The ERG parameters in the ROP subjects were compared with normal values for age. Twelve ROP subjects developed early ametropia, 10 myopia, and two hyperopia. In the majority of ROP subjects, receptoral and postreceptoral response parameters were below the normal mean for age. In the 12 children with early ametropia, rod photoreceptor sensitivity was significantly lower than in emmetropic ROP subjects; and in five tested in infancy, deficits in rod photoreceptor sensitivity antedated development of ametropia. The myopic control subjects had no deficits in response parameters. Retinal dysfunction is significantly associated with early ametropia in these ROP subjects. Thus, mechanisms for the development of ametropia in ROP subjects may involve rod and rod-mediated postreceptoral activity.