Laser speckle flowgraphy (LSFG) in retinal vein occlusion and central serous chorioretinopathy: a systematic review of the recent literature

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Abstract Purpose Laser Speckle Flowgraphy (LSFG) is a non-invasive imaging technology that quantitatively evaluates retinal and choroidal blood flow by analyzing speckle patterns generated by laser light scattering. Compared with OCT-A, which provides detailed visualization of retinal and choroidal microvascular architecture, LSFG offers dynamic quantitative information on ocular blood flow. This systematic review summarizes the application of LSFG in two major vascular diseases: retinal vein occlusion (RVO), and central serous chorioretinopathy (CSCR). Methods This second part of a PRISMA-guided systematic review evaluates LSFG in RVO and CSCR, including studies published in English retrieved throughout a comprehensive literature search (2010–2025) conducted in PubMed, Cochrane Library and EMBASE. Results Twenty-nine studies (966 eyes: 700 RVO, 266 CSCR) were analyzed. Across retinal vein occlusion, LSFG consistently showed that lower retinal mean blur rate (MBR) associates with higher VEGF/other cytokines, greater ischemia, and worse visual prognosis, while higher baseline or early post-injection MBR predicts better central macular thickness reduction, fewer recurrences, and superior visual recovery. total capillary resistance correlated with clinical severity and visual outcomes. In CSCR, elevated choroidal MBR during the acute phase and its reduction after photodynamic therapy highlighted choroidal hyperperfusion as a key pathogenic mechanism. Conclusions LSFG captures rapid, reproducible, and non-invasive functional perfusion and vascular-resistance dynamics in RVO and CSCR, complementing OCT-A structural microvascular metrics. Despite heterogeneity and the lack of meta-analysis, LSFG integration into multimodal imaging appears clinically valuable for early diagnosis, risk stratification, treatment monitoring, and the support of individualized care pathways in retinal and choroidal vascular disorders.