Laser Speckle Flowgraphy Assessment of Ocular Blood Flow in School‐Aged Children With or Without a History of Retinopathy of Prematurity

Background To evaluate ocular blood flow in school‐aged children born prematurely, with or without retinopathy of prematurity (ROP), using laser speckle flowgraphy (LSFG), and to determine factors associated with LSFG‐derived parameters. Methods This cross‐sectional observational study included 123 school‐aged preterm children: 54 without ROP, 20 with untreated type 2/mild ROP, and 49 with treated type 1 ROP. All participants underwent ophthalmic examinations and optic nerve head (ONH) perfusion assessments using LSFG. Mean blur rate indices of the entire ONH (MA), vessel area (MV), and tissue area (MT) of the right eye were analysed. Multivariable generalised linear models were used to identify variables associated with LSFG parameters, and Pearson's correlation was used to examine the association between axial length and MT. Results Children with type 1 ROP had lower MA, MV, and MT than those with type 2/mild ROP, whereas MV was the highest in the type 2/mild ROP group. Type 1 ROP was independently associated with reduced MA and MV in the full cohort. Among children with ROP, anti‐vascular endothelial growth factor (VEGF) treatment was associated with lower MA, MV, and MT. Longer axial length correlated with reduced MT in both the full cohort ( r = −0.30, p < 0.01) and the ROP subgroup (r = −0.35, p < 0.01). Conclusions Type 1 ROP was associated with reduced ocular blood flow in school‐aged children born preterm. Among eyes with ROP, a history of anti‐VEGF treatment was associated with lower MA, MV, and MT, although this may reflect disease severity.