# Reference ranges of light-adapted full-field electroretinogram and associated factors in a large cohort of healthy school-aged children and adolescents

## TL;DR

This study establishes reference ranges for light-adapted electroretinograms in healthy children and adolescents and explores how eye measurements relate to these readings.

## Contribution

The study provides a new reference dataset for light-adapted full-field electroretinograms in children and adolescents.

## Key findings

- More myopic refraction and longer axial length were associated with delayed and reduced electroretinogram waveforms.
- Older age and male sex showed weak correlations with electroretinogram parameters with minimal clinical significance.

## Abstract

This study aimed to establish a reference data set of light-adapted full-field electroretinograms (ffERG) of healthy primary and secondary schoolchildren and investigate the relationship among refraction, ocular biometry, and ffERG.

Healthy children aged between 6 and 17 years were recruited. Cycloplegic spherical equivalent refraction (SER), axial length (AL) and keratometry (K) measurements were performed. Standardized ffERGs, including light-adapted flash and 30-Hz flicker, were measured using a portable device with skin electrodes. The percentiles of peak time and amplitude of a- and b-waves and 30-Hz flicker of ffERG waveform were reported, and their relationships with age, SER, AL, K were investigated.

Among the 445 participants (45.4% female), the SER (mean ± standard deviation) was − 0.72 ± 2.06 D and AL was 23.56 ± 1.15 mm. The 90% confidence interval (CI) of 5th reference limit of amplitudes of a- and b-wave were 5.0–5.8 µV and 15.0–17.6 µV, while 95th reference limit of peak times were 13.2–13.4 ms and 29.8–30.0 ms, respectively. The amplitude and peak time of the 30-Hz flicker waveform were 21.5–23.9 µV and 26.0–26.2 ms, respectively. In general, more myopic SER, and longer AL were associated with delayed and reduced ffERG waveforms. Older age and male sex were weakly correlated with ffERGs with minimal clinical significance.

A reference data set of light-adapted ffERG in children and adolescents was established for clinical and research purposes.

The online version contains supplementary material available at 10.1007/s10633-025-10015-4.