Using Laser Speckle Contrast Imaging and Intravenous Fluorescein Angiography to determine blood flow in infants with Retinopathy of Prematurity

Abstract

Purpose : A novel imaging modality, laser speckle contrast imaging (LSCI), can provide non-invasive blood flow metrics in the management of retinopathy of prematurity (ROP). Current standard of care involves binocular indirect ophthalmoscopy and intravenous fluorescein angiography (IVFA) in select cases, which is invasive yet provides objective metrics about blood flow. We performed a prospective, comparative clinical study to test the hypothesis that blood flow velocity indices (BFVi) as measured by LSCI are negatively correlated with artery-vein transit times (AVTT) as measured by IVFA to determine the clinical utility of LSCI in ROP management.

Methods : Ten patients underwent IVFA imaging, with seven of those also receiving LSCI imaging. Seven LSCI metrics were obtained using the XyCAM software, while five IVFA metrics were obtained by visualizing filling times and using ImageJ with an overlay of both modalities in the same eye. Pearson correlation coefficients were analyzed between all LSCI and IVFA metrics.

Results : There were five statistically significant correlations, between AVTT and peak BFVi (r = -0.917, p = 0.004), dip BFVi (r = -0.920, p = 0.003), mean BFVi (r = -0.927, p = 0.003), volumetric rise index (r = -0.779, p = 0.039), and between laminar filling time (IVFA) and the time to fall (LSCI) (r = 0.903, p = 0.014).

Conclusions : Our results support the hypothesis that AVTT as measured by IVFA is negatively correlated with BFVi as measured by LSCI. Expanding this analysis to include more subjects with moderate ROP could highlight some metrics that allow us to differentiate severity of disease, since IVFA is reserved for particularly severe ROP requiring prompt treatment. This may provide evidence for LSCI use in infants that are particularly sensitive to the standard binocular indirect ophthalmoscopy examination, have contraindications to receiving IVFA, and/or those that do not have access to an expert pediatric ophthalmologist.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.