Dynamic Optical Coherence Tomography Imaging of Telangiectasia Prior to Intense Pulsed Light Treatment—An Opportunity to Target Treatment?

Abstract

Background and Objectives To investigate whether optical coherence tomography (OCT) could be utilized to characterize blood flow and vessel dimensions of facial telangiectasias before and during consecutive intense pulsed light (IPL) treatment. Study Design/Materials and methods Dynamic OCT (D‐OCT) was used to image telangiectasia immediately before and after, 1–3 days after, and 1 month after IPL treatment. Measurements included vessel width and depth, blood flow, and attenuation. Vessel dimensions at baseline were verified by a blinded observer. Clinical improvement was detected as good, moderate, or none, and adverse effects were registered at 1‐month follow‐up. Results In total, 14 patients with facial telangiectasia were included. At baseline, vessel width was median 0.25 mm (interquartile range [IQR]: 0.19–0.34 mm) with an intra‐class coefficient (ICC) of 0.89 (95% confidence interval [CI]: 0.70; 0.97). Vessel depth was 0.30 mm (IQR: 0.25–0.33 mm; ICC: 0.40 [CI: −0.07; 0.75]). Vessel depth increased significantly from baseline to 1‐month follow‐up (P = 0.008), whereas no significant changes in vessel width, blood flow, or attenuation were detected. Clinical efficacy seemed related to the relation between vessel dimensions and applied energy settings. Conclusions The D‐OCT imaging technique demonstrated that facial telangiectasias were found deeper within the skin after one IPL treatment. By characterizing the vessel dimensions and blood flow of telangiectasia, D‐OCT may improve efficacy and safety of IPL. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

Intense Pulsed Light as a Treatment for Senile Purpura: A Pilot Study

“…However, all of these have very limited results, if any, and there have been no large‐scale studies proving their long‐term efficacy for this condition. Considering IPL is used to decrease postprocedural purpura [28,32], is associated with a significantly altered expression of RNAs similar to that in youthful skin [37], decreases superficial telangiectasia [27], and increases collagen production and epidermal thickening [20], it appears to be an ideal option for the treatment and prevention of senile purpura.…”

“…In addition, studies utilizing IPL for rosacea have shown a clinically significant reduction in telangiectasia and redness [25,26] and improvement in skin texture [26]. In fact, a study directly analyzing telangiectasias has shown that superficial telangiectasias were preferentially reduced with IPL on analysis with dynamic optical coherence tomography (D‐OCT) [27].…”

“…In reviewing the studies mentioned above showing clinical improvement both in the appearance of bruising with IPL [28], the decrease in superficial telangiectasia [27], increased dermal thickness and collagen production up to 6 months after treatment [20], as well as its large spot size, we hypothesized that IPL is not only an ideal immediate treatment for large areas of purpura but may also be an ideal preventative treatment for senile purpura.…”

Light-Based Devices for the Treatment of Facial Erythema and Telangiectasia

“…Better visualization of blood flow and vessel dimensions may help to improve the results of treatment with IPL [35].…”

Neues von der optischen Kohärenztomographie

“…Zum Beispiel zeigte sich die D-OCT dafür geeignet, die Verengung und Verdün-nung der Blutgefäße nach der lokalen Behandlung der Rosazea mit dem α-2-adrenergen Rezeptoragonist Brimonidin zu erfassen [27]. Im Fall von Teleangiektasien im Gesicht konnte festgestellt werden, dass diese sich nach einer Behandlung mit "intense pulsed light" (IPL) tiefer in die Haut zurückzogen, was darauf hindeutet, dass eine routinemäßige IPL-Behandlung in erster Linie auf die oberflächlichsten Gefäße wirkt [28]. Die D-OCT-Bildgebung könnte insofern in der IPL-Nachbehandlung gezielt eingesetzt werden.…”