Assessing the impact of aging and blood pressure on dermal microvasculature by reactive hyperemia optical coherence tomography angiography

Wang-Evers, Michael; Casper, Malte; Glahn, Joshua; Luo, Tuanlian; Doyle, Abigail E.; Karasik, Daniel; Kim, Anne C.; Phothong, Weeranut; Nathan, Neera; Heesakker, Tammy; Kositratna, Garuna; Manstein, Dieter

doi:10.1038/s41598-021-92712-z

Cited by 12 publications

(18 citation statements)

References 69 publications

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“…The most reported metrics are VAD and mean diameter. Most reported values for VAD obtained using OCTA fall within the range 10-40% over a variety of skin sites 2,10,[34][35][36][37] ; the values measured during this study fall within this range (we measured an average VAD of 37% in the hand and 34% in the foot over all participants). Similarly, reported values for mean vessel diameter in the skin of the arm and leg lie in the range 31-70 µm.…”

Section: Metrics At Baseline In Healthy Participantssupporting

confidence: 63%

Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic people

Untracht

Δικαίος

Durrani

et al. 2023

Sci Rep

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Optical coherence tomography angiography (OCTA) is a non-invasive, high-resolution imaging modality with growing application in dermatology and microvascular assessment. Accepted reference values for OCTA-derived microvascular parameters in skin do not yet exist but need to be established to drive OCTA into the clinic. In this pilot study, we assess a range of OCTA microvascular metrics at rest and after post-occlusive reactive hyperaemia (PORH) in the hands and feet of 52 healthy people and 11 people with well-controlled type 2 diabetes mellitus (T2DM). We calculate each metric, measure test–retest repeatability, and evaluate correlation with demographic risk factors. Our study delivers extremity-specific, age-dependent reference values and coefficients of repeatability of nine microvascular metrics at baseline and at the maximum of PORH. Significant differences are not seen for age-dependent microvascular metrics in hand, but they are present for several metrics in the foot. Significant differences are observed between hand and foot, both at baseline and maximum PORH, for most of the microvascular metrics with generally higher values in the hand. Despite a large variability over a range of individuals, as is expected based on heterogeneous ageing phenotypes of the population, the test–retest repeatability is 3.5% to 18% of the mean value for all metrics, which highlights the opportunities for OCTA-based studies in larger cohorts, for longitudinal monitoring, and for assessing the efficacy of interventions. Additionally, branchpoint density in the hand and foot and changes in vessel diameter in response to PORH stood out as good discriminators between healthy and T2DM groups, which indicates their potential value as biomarkers. This study, building on our previous work, represents a further step towards standardised OCTA in clinical practice and research.

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Section: Metrics At Baseline In Healthy Participantssupporting

confidence: 63%

Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic people

Untracht

Δικαίος

Durrani

et al. 2023

Sci Rep

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“…In another study done by Soomro SA et al 107 an incidence of seroma in 61% in hypertensive patients as compare to 5% in normotensive patients with relative risk of 12.72% ( 16) Given that age is generally associated with high blood pressure due to vascular sclerosis and nephropathy, our finding that hypertension was related to seroma production in the univariate rather than multivariate analysis is not surprising and is backed up by numerous other studies. (17,18). Seromas can be created by inflammatory exudation or lymphogenous effusion, hence it is thought that increased blood pressure leads to seroma formation, most likely through extended contact area secretion.…”

Section: Discussionmentioning

confidence: 99%

Raised Blood Pressure as a Risk Factor of Post-Operative Seroma Formation in Patients of Modified Radical Mastectomy

Anjum¹,

Naseer²,

Rafique³

et al. 2022

PJMHS

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Despite seroma is rarely potentially lethal and is typically harmless, it can cause considerable sequelae such as flap necrosis, wound dehiscence, predisposes to infection. The objective of the study was to determine the association of raised blood pressure as a risk factor of development of seroma after MRM in breast cancer patients. Material Methods: In this case control study, all women of age 30 to 70 years with MRM done for carcinoma of the breast of stage T2 and lymph nodes N2 were enrolled and followed for 3 days after MRM surgery for seroma formation. Out of total 122 patients, 64 patients were cases and 58 controls. Patients with disease upto N2 had level 2 clearances with upfront surgery. Age, history of essential hypertension, compression bandage applied, serum albumin level, seroma formation and volume of seroma on 3rd post-operative day was documented. Results: Mean age of the patients was 51.2 + 9.5 years and 53.5 + 10.8 years in case and control, respectively. Majority of the patients were of the age group 40 to 50 year’s age group. 56.3% (n=36) cases and 43.8% (n= 28) controls had history of essential hypertension. Seroma formation was seen in cases 51% (n=31) as compare to controls 13% (n= 8) with odd ratio OR 1.48. Drainage volume among two groups was analyzed as in case group, the drainage volume was 148.1 + 76.4 ml (range 50 to 290) while in control group the drainage volume was 130 + 56.9 ml (60 to 250) and was statistically significant with p-value <0.001. Conclusion: Although the pathogenesis of seroma remains controversial, hypertension is the most consistent significant risk factor for seroma formation subsequent to modified radical mastectomy for carcinoma breast. Good pre, peri and post-operative blood pressure control can reduce the risk of seroma formation and the associated morbidity. Keywords: MRM, Seroma, nodal clearance, breast cancer,

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“…The laser scanning handpiece uses a plastic tip as a distance holder between optical component and skin surface. The distance holder was gently placed onto the skin to avoid pressure- or shear-induced effects on the vessel diameter ( 28 ). Terminal hair was carefully trimmed.…”

Section: Methodsmentioning

confidence: 99%

Case report: Optical coherence tomography for monitoring biologic therapy in psoriasis and atopic dermatitis

et al. 2022

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Biologic therapies are increasingly used to treat chronic inflammatory skin diseases such as psoriasis and atopic dermatitis. In clinical practice, scores based on evaluation of objective and subjective symptoms are used to assess disease severity, leading to evaluation of treatment goals with clinical decisions on treatment initiation, switch to another treatment modality or to discontinue current treatment. However, this visual-based scoring is relatively subjective and inaccurate due to inter- and intraobserver reliability. Optical coherence tomography (OCT) is a fast, high-resolution, in vivo imaging modality that enables the visualization of skin structure and vasculature. We evaluated the use of OCT for quantification and monitoring of skin inflammation to improve objective assessment of disease activity in patients with psoriasis and atopic dermatitis. We assessed the following imaging parameters including epidermal thickness, vascular density, plexus depth, vessel diameter, and vessel count. A total of four patients with psoriasis or atopic dermatitis were treated with biologic agents according to current treatment guidelines. OCT was used to monitor their individual treatment response in a target lesion representing disease activity for 52 weeks. Psoriatic and eczema lesions exhibited higher epidermal thickness, increased vascular density, and higher vessel count compared to uninvolved skin. An upward shift of the superficial vascular plexus accompanied by smaller vessel diameters was seen in psoriasis in contrast to atopic dermatitis, where larger vessels were observed. A response to biologic therapy was characterized by normalization of the imaging parameters in the target lesions in comparison to uninvolved skin during the observation period of 52 weeks. Optical coherence tomography potentially serves as an instrument to monitor biologic therapy in inflammatory skin diseases. Imaging parameters may enable objective quantification of inflammation in psoriasis or atopic dermatitis in selected representative skin areas. OCT may reveal persistent subclinical inflammation in atopic dermatitis beyond clinical remission.

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Assessing the impact of aging and blood pressure on dermal microvasculature by reactive hyperemia optical coherence tomography angiography

Cited by 12 publications

References 69 publications

Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic people

Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic people

Raised Blood Pressure as a Risk Factor of Post-Operative Seroma Formation in Patients of Modified Radical Mastectomy

Case report: Optical coherence tomography for monitoring biologic therapy in psoriasis and atopic dermatitis

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