Ocular blood flow associations with retinopathy of prematurity heart rate and blood pressure

Abstract

Purpose : Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants. The standard of care screening for neonates at risk is binocular indirect ophthalmoscopy (BIO). Laser speckle contrast imaging (LSCI) is a novel non-contact method for quantifying retinal blood flow using erythrocyte motion with insufficient investigation for utility in ROP. The purpose of this study is to find an association between LSCI blood flow metrics (BFM) and key cardiovascular vital signs: blood pressure and heart rate.

Methods : In this prospective 2-year study, 46 infants (68 eyes) received ROP screening weekly or biweekly with BIO and LSCI, during which their vitals were recorded. Correlation testing and linear regression analyses were performed to evaluate the relationship between heart rate (HR), blood pressure, and BFM.

Results : Mean HR and mean arterial pressure (MAP) were 153.3 ± 14.8 beats/min and 56.9 ± 10.8 mmHg, respectively. HR was significantly correlated with acceleration time index (r = 0.25, p = 0.02). The systolic blood pressure was significantly correlated with peak blood flow velocity (r = 0.33, p = 0.01) and dip blood flow velocity (DBFV) (r = 0.32, p = 0.01). MAP was a significant predictor for DBFV (β = -28.6 [-51.8, -5.47], p = 0.02), rising and falling mean blood flow velocity (β = -23.9 [-44.8, -3.11], p = 0.03; β = -22.6 [-43.6, -1.59], p = 0.04), and maximal stage of ROP presentation (β = -9.83 [-18.4, -1.24], p = 0.03). MAP, maximum HR, minimum HR, and average HR during exam were significant predictors of current ROP stage (β = -8.76 [-15.9, -1.64], p = 0.02; β = 1.26 [0.20, 2.32], p = 0.02; β = 1.72 [0.11, 3.32], p = 0.04; β = 1.62 [0.25, 2.98], p = 0.02), controlling for gestational age and birth weight, which have known associations with BFM.

Conclusions : Ocular blood flow velocities quantified by LSCI are associated with HR and blood pressure in neonates at risk for or diagnosed with ROP. These results elaborate on the associations between systemic and ocular hemodynamics, further supporting existing research into LSCI as a dynamic tool to objectively assess deviations in blood flow in relation to ROP disease states.

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