Skin Vasculature & Blood Flow

VivoSight Dx produces and characterizes vascular network images

Understanding cutaneous vascular presentations is a prerequisite for effective research programs including:

  • Clinical research involving systemic and topical medications
  • Optimization of treatment parameters for lasers, energy devices etc.
inflammatory reaction skin blood vessels VivoSight OCT
Dramatic inflammatory reaction after topical exposure of skin to capsaicin. Left: vascular pattern of medial aspect of forearm of middle-age male. Right: adjacent site at same depth after exposure to capsaicin from Habanero pepper

Besides imaging vascular networks, VivoSight Dx and VivoTools measure the following vascular properties:

  • Vessel density by depth
  • Depth of the superficial vascular plexus
  • Modal vessel diameter of the superficial plexus
  • Density of vessels at the plexus level
Quantify treatment effects by measuring vessel density before and after treatment

VivoSight Dx Measurements Can Enhance Research of Inflammatory and Vascular Conditions:

Psoriasis

In addition to marked morphologic differences (thickened and bright stratum corneum, acanthosis), the number of blood vessels and vascular density is increased in psoriasis. Images courtesy of Welzel [3].

 

Psoriasis skin blood vessels VivoSight OCT
Psoriasis (top) compared to healthy adjacent skin (bottom). Especially in the upper stratum papillare, loops of dilated capillaries are present (arrows) [3]

Rosacea Therapy (Brimonidine)

Dynamic OCT en-face view of normal skin located on the cheek before (left) and 60 minutes after topical brimonidine (right).

Rosacea therapy brimonidine VivoSight OCT
Images shows a reduced number of vessels after application, however many of the medium to large vessels are still visible (right). Yellow bars indicate the location where measurements of vessel diameter were performed. The measurements showed a reduced vessel diameter of 42% after the application of brimonidine (diameter at baseline: 0.08 mm; diameter after brimonidine application: 0.046 mm). Images courtesy of Themstrup [5]

Port Wine Stain Birthmarks and Rosacea

VivoSight Dx uncovers a wide variability of quantified vascular morphology requiring different, individual treatment approaches with lasers and energy device

VivoSight Scans Show Highly Variable Architecture for a Variety of Vascular Lesions

En-face dynamic OCT scans of five port wine birthmarks, five hemangiomas, and two from normal skin. Images courtesy of Waibel [1]
Histograms of vessel diameters at three selected depths in a hemangioma. From this data it is possible to estimate both the cross-sectional area and the volume of vessels of a particular diameter range and depth range that is to be treated by laser.

References:

1. Waibel JS, Holmes J, Rudnick A, Woods D, Kelly KM. Angiographic optical coherence tomography imaging of hemangiomas and port wine birthmarks. Lasers Surg Med. 2018 Mar 22

2. Christman MP, Feng H, Holmes J, Geronemus RG. Treating port wine stain birthmarks using dynamic optical coherence tomography-guided settings. J Am Acad Dermatol. 2019 Aug 19.

3. Ulrich M, Themstrup L, de Carvalho N, Manfredi M, Grana C, Ciardo S, Kästle R, Holmes J, Whitehead R, Jemec G, B, E, Pellacani G, Welzel J: Dynamic Optical Coherence Tomography in Dermatology. Dermatology 2016;232:298-311. doi: 10.1159/000444706

4. Schuh S, Holmes J, Ulrich M, Themstrup L, Jemec GBE, Pellacani G, Welzel J. Imaging blood vessel morphology in skin: dynamic optical coherence tomography as a novel potential diagnostic tool in dermatology. Dermatol Ther (Heidelb). 2017;7(2):187–202

5. Themstrup L, Ciardo S, Manfredi M, Ulrich M, Pellacani G, Welzel J, Jemec GBE. In vivo, micro-morphological vascular changes induced by topical brimonidine studied by Dynamic optical coherence tomography. J Eur Acad Dermatol Venereol. 2016 Jun;30(6):974-9

6. Themstrup, L., et al., Validation of Dynamic optical coherence tomography for non-invasive, in vivo microcirculation imaging of the skin, Microvasc. Res. (2016), Shttp://dx.doi.org/10.1016/j.mvr.2016.05.004

7. Byers RA, Fisher M, Bown NJ, Tozer GM, Matcher SJ. Vascular patterning of subcutaneous mouse fibro sarcomas expressing individual VEGF isoforms can be differentiated using angiographic optical coherence tomography. Biomedical Optics Express (BOE) Vol. 8, No. 10 | 1 Oct 2017.