Evaluation of ocular blood flow in children with retinopathy of prematurity using laser speckle flowgraphy

BACKGROUND: Retinopathy of prematurity is a vasoproliferative eye disease defined by disrupted retinal angio- and vasculogenesis caused by premature birth. However, vascular disorders associated with retinopathy of prematurity are considered to precede anatomical changes and contribute to retinal dystrophy, affecting its development and reducing visual functions. AIM: The work aimed to study ocular blood flow in infants with cicatricial retinopathy of prematurity using laser speckle flowgraphy. METHODS: An observational, single-center, cross-sectional study was performed. This study included the following three groups: children with history of active retinopathy of prematurity (study group); healthy children without the disease (control group); full-term children with moderate or high myopia (comparison group). In addition, the study group was divided into four subgroups by the degree of cicatricial retinopathy of prematurity of grade 0 (subgroup 1), grade 1 (subgroup 2), grade 2 (subgroup 3), and grade 3 (subgroup 4). Blood flow was studied in the area of the optic disk and macula using LSFG RetFlow in all patients. RESULTS: The study enrolled 41 children (82 eyes). The study group included 26 children (52 eyes) aged 5–17 years (mean age 11 ± 4 years) with cicatricial retinopathy of prematurity (11 girls and 15 boys). The control group included 6 healthy children without any disease signs. The comparison group included 9 full-term children with moderate or high myopia. Blood flow was decreased in the temporal quadrant of the optic disk, with the greatest reduction in blood flow velocity in large vessels, which was noted in all study groups. This parameter decreased by 11.5% and 18.7% in subgroups 3 and 4, respectively, compared with the control, which indicated hemodynamic compromise associated with retinopathy of prematurity. A significant decrease in mean blood flow velocity in the optic disc microvessels was observed only in subgroup 4. In addition, these parameters decreased in the macular area, which suggested a deficiency of chorioretinal blood flow, which worsened with increasing severity of residual fundus changes in cicatricial retinopathy of prematurity. CONCLUSION: Changes in blood flow parameters, observed even with minimal residual fundus changes, demonstrate the important role of hemodynamic abnormalities both in the pathogenesis of retinopathy of prematurity and in visual dysfunction, which highlights the need for further research.