Association between ocular blood flow and retinopathy of prematurity stage and severity using laser speckle contrast imaging

Abstract

Purpose : Retinopathy of prematurity (ROP) stage and the presence or absence of plus disease serve as the two key diagnostic features on which ophthalmologists base treatment decisions. The timing of treatment has implications for long-term vision outcomes. We conducted a prospective observational study to investigate the use of laser speckle contrast imaging (LSCI) to evaluate the association between the optic nerve head's quantitative blood flow velocity index and ROP stage and the presence or absence of plus disease. We hypothesized that increased stage and plus disease would be associated with increased blood flow velocity index.

Methods : 40 premature infants aged 4 to 21 weeks (11±5) were enrolled. This cohort had a mean gestational age of 27±3 weeks, and birthweight of 980±340 grams. Standard ROP screening using indirect ophthalmoscopy and LSCI imaging was performed for all subjects. LSCI blood flow velocity (BFV) associations with ROP stage, and presence or absence of plus disease, were conducted using multivariable mixed effect logistic regression. Student’s two-tailed t-test was used to compare mean BFV in subjects with/without plus disease and with/without stage≥3.

Results : Regression results found BFV increased by 0.7 (p=0.08) for each increase in current ROP stage. BFV increased by 0.8 (p=0.03) for each increase in maximal ROP stage. Among subjects with plus disease, mean BFV was 10.3±2.1 as compared to 8.3±2.5 in subjects without plus disease (p=0.07). Among subjects with concurrent stage 3 or tortuosity or plus disease, mean BFV was 11.4±5.8 vs. 7.7±2.2 (p=0.003). Among subjects with concurrent or future stage 3/tortuosity/plus disease, mean BFV was 10.8±5.1 vs. 7.3±2.2 (p=0.0003). Tortuosity was associated with increased mean BFV (p=0.002). Mortality was also associated with increased BFV (p=0.04).

Conclusions : Increased BFV is associated with stage 3 ROP, plus disease, and tortuosity. Associations between BFV and future ROP severity were stronger than for current ROP severity. Further study is needed to determine if BFV predicts future ROP stage rather than current stage.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.