Ocular Blood Flow in Preterm Neonates: A Preliminary Report

Area of Science:

• Ophthalmology
• Neonatology
• Medical Imaging

Background:

• Retinopathy of prematurity (ROP) is a leading cause of vision loss in premature infants.
• Current ROP screening involves dilated ophthalmoscopy, which can be stressful and morbid for neonates.
• There is a need for non-invasive, quantitative methods to assess ROP risk and severity.

Purpose of the Study:

• To evaluate the utility of plane-wave ultrasound (PWUS) for imaging and measuring retrobulbar blood flow velocities in preterm neonates.
• To assess the correlation between blood flow velocities and ROP stages.
• To determine if PWUS can provide a quantitative measure for ROP assessment.

Main Methods:

• 18 MHz PWUS was used to examine both eyes of 14 preterm neonates at risk for ROP.
• Color-flow images and spectrograms were generated to visualize flow in the central retinal artery (CRA), central retinal vein (CRV), and short posterior ciliary arteries (SPCA).
• Flow parameters were compared across different ROP stages (0-3).

Main Results:

• ROP stage significantly correlated with retrobulbar blood flow velocities.
• Elevated velocities were observed in all assessed vessels at ROP stage 3 and in the SPCAs at stage 2 compared to non-ROP eyes.
• PWUS successfully imaged and measured blood flow in these delicate neonatal ocular vessels.

Conclusions:

• PWUS offers a quantitative, well-tolerated method for detecting and assessing ROP risk in preterm neonates.
• Increased flow velocity may be linked to elevated vascular endothelial growth factor (VEGF) in ROP eyes.
• PWUS serves as a complementary, nonmydriatic tool for ROP monitoring, enhancing current clinical practice.