Clinical and electroretinographic findings in fetal alcohol syndrome

Purpose: Fetal exposure to alcohol is a serious public health problem and is associated with anomalies of the eye ground, as well as neurodevelopmental delay, growth delay, and characteristic facial features. Our purpose is to report the incidence of abnormal electroretinogram (ERG) results in children with fetal alcohol syndrome and raise awareness of the diagnosis of fetal alcohol syndrome in ophthalmology. Methods: A retrospective review was performed on the records of 11 children with the diagnosis of fetal alcohol syndrome. The results of the ophthalmologic examination, magnetic resonance imaging, visual acuity test, and ERG are reported. Results: The magnetic resonance imaging results were abnormal in all subjects tested. The ophthalmology examination showed optic nerve hypoplasia in 91% of the subjects. Visual acuity was reduced in all but one subject. The ERG results were abnormal, showing reduced b-wave amplitude, increased a- and b-wave implicit time, reduced Rmax, and increased log (k). The scotopic ERG was more severely affected than the photopic ERG. Conclusions: Prenatal alcohol exposure can lead to changes in retinal function as evidenced by an abnormal ERG response. The ERG can therefore be a tool with which to identify suspected alcohol embryopathy. (J AAPOS 2000;4:200–4)