Optical Coherence Tomography Angiography Enables Visualization of Microvascular Patterns in Chronic Venous Insufficiency

Overview

Journal iScience

Publisher Cell Press

Date 2025 Jan 6

PMID 39759076

Authors

Giulia Rotunno

Julia Deinsberger

Kristen M Meiburger

Lisa Krainz

Lukasz Bugyi

Valentin Hacker

Richard Haindl

Rainer Leitgeb

Christoph Sinz

Leopold Schmetterer

Wolfgang Drexler

Benedikt Weber

Mengyang Liu

Affiliations

Soon will be listed here.

Abstract

Chronic venous insufficiency (CVI) is a global health concern with significant public health and individual impact. Currently available diagnostic methods cannot visualize microvenous pathologies that have shown to result in severe forms of CVI and also affect the skin. Optical coherence tomography angiography (OCTA) may close the CVI diagnostic gap by providing a fast, label-free, and non-invasive solution to visualize cutaneous microvasculature. The study enlisted 66 subjects, including 53 CVI patients spanning all clinical-etiology-anatomic-pathophysiologic (CEAP) C stages and 13 healthy controls. The high spatial resolution OCTA system used was specifically designed for skin imaging. Significant microangiographic pattern variations emerged, both in qualitative and quantitative terms. OCTA provided valuable insights into cutaneous microvascular changes among different CVI stages. Thereby, OCTA may enable the selection of patient populations at risk for disease progression in the future.

References

Mahmud M, Cadotte D, Vuong B, Sun C, Luk T, Mariampillai A . Review of speckle and phase variance optical coherence tomography to visualize microvascular networks. J Biomed Opt. 2013; 18(5):50901. DOI: 10.1117/1.JBO.18.5.050901. View

Sampson D, Dubis A, Chen F, Zawadzki R, Sampson D . Towards standardizing retinal optical coherence tomography angiography: a review. Light Sci Appl. 2022; 11(1):63. PMC: 8933532. DOI: 10.1038/s41377-022-00740-9. View

Chen Z, Liu M, Minneman M, Ginner L, Hoover E, Sattmann H . Phase-stable swept source OCT angiography in human skin using an akinetic source. Biomed Opt Express. 2016; 7(8):3032-48. PMC: 4986811. DOI: 10.1364/BOE.7.003032. View

Lurie F, Passman M, Meisner M, Dalsing M, Masuda E, Welch H . The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020; 8(3):342-352. DOI: 10.1016/j.jvsv.2019.12.075. View

Carpentier P, Trolliet C, Cornu-Thenard A, Chamberod R, Laures J, Noilhetas J . Video-capillaroscopy, a promising tool for the clinical evaluation of patients with chronic venous insufficiency. Front Med (Lausanne). 2023; 10:1144102. PMC: 9978444. DOI: 10.3389/fmed.2023.1144102. View

Chen Z, Rank E, Meiburger K, Sinz C, Hodul A, Zhang E . Non-invasive multimodal optical coherence and photoacoustic tomography for human skin imaging. Sci Rep. 2017; 7(1):17975. PMC: 5740114. DOI: 10.1038/s41598-017-18331-9. View

. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310(20):2191-4. DOI: 10.1001/jama.2013.281053. View

Niederleithner M, de Sisternes L, Stino H, Sedova A, Schlegl T, Bagherinia H . Ultra-Widefield OCT Angiography. IEEE Trans Med Imaging. 2022; 42(4):1009-1020. DOI: 10.1109/TMI.2022.3222638. View

Perwein M, Welzel J, De Carvalho N, Pellacani G, Schuh S . Dynamic Optical Coherence Tomography: A Non-Invasive Imaging Tool for the Distinction of Nevi and Melanomas. Cancers (Basel). 2023; 15(1). PMC: 9817967. DOI: 10.3390/cancers15010020. View

10.

Santamaria R, Gonzalez-Alvarez M, Delgado R, Esteban S, Arroyo A . Remodeling of the Microvasculature: May the Blood Flow Be With You. Front Physiol. 2020; 11:586852. PMC: 7593767. DOI: 10.3389/fphys.2020.586852. View

11.

Zabihian B, Weingast J, Liu M, Zhang E, Beard P, Pehamberger H . In vivo dual-modality photoacoustic and optical coherence tomography imaging of human dermatological pathologies. Biomed Opt Express. 2015; 6(9):3163-78. PMC: 4574645. DOI: 10.1364/BOE.6.003163. View

12.

Veselka L, Krainz L, Mindrinos L, Drexler W, Elbau P . A Quantitative Model for Optical Coherence Tomography. Sensors (Basel). 2021; 21(20). PMC: 8539377. DOI: 10.3390/s21206864. View

13.

Rank E, Sentosa R, Harper D, Salas M, Gaugutz A, Seyringer D . Toward optical coherence tomography on a chip: in vivo three-dimensional human retinal imaging using photonic integrated circuit-based arrayed waveguide gratings. Light Sci Appl. 2021; 10(1):6. PMC: 7785745. DOI: 10.1038/s41377-020-00450-0. View

14.

Meiburger K, Chen Z, Sinz C, Hoover E, Minneman M, Ensher J . Automatic skin lesion area determination of basal cell carcinoma using optical coherence tomography angiography and a skeletonization approach: Preliminary results. J Biophotonics. 2019; 12(9):e201900131. PMC: 7065618. DOI: 10.1002/jbio.201900131. View

15.

Kolano P, Bednarski I, Lesiak A, Skibinska M, Stasikowska-Kanicka O, Danilewicz M . Overexpression of cathepsin K and vascular endothelial growth factor in chronic venous ulcerations. Postepy Dermatol Alergol. 2020; 37(2):234-239. PMC: 7262799. DOI: 10.5114/ada.2020.94840. View

16.

Liu M, Drexler W . Optical coherence tomography angiography and photoacoustic imaging in dermatology. Photochem Photobiol Sci. 2019; 18(5):945-962. DOI: 10.1039/c8pp00471d. View

17.

Robertson L, Evans C, Fowkes F . Epidemiology of chronic venous disease. Phlebology. 2008; 23(3):103-11. DOI: 10.1258/phleb.2007.007061. View

18.

Holmes J, Schuh S, Bowling F, Mani R, Welzel J . Dynamic Optical Coherence Tomography Is a New Technique for Imaging Skin Around Lower Extremity Wounds. Int J Low Extrem Wounds. 2019; 18(1):65-74. DOI: 10.1177/1534734618821015. View

19.

Wrona M, Jockel K, Pannier F, Bock E, Hoffmann B, Rabe E . Association of Venous Disorders with Leg Symptoms: Results from the Bonn Vein Study 1. Eur J Vasc Endovasc Surg. 2015; 50(3):360-7. DOI: 10.1016/j.ejvs.2015.05.013. View

20.

Bullitt E, Gerig G, Pizer S, Lin W, Aylward S . Measuring tortuosity of the intracerebral vasculature from MRA images. IEEE Trans Med Imaging. 2003; 22(9):1163-71. PMC: 2430603. DOI: 10.1109/TMI.2003.816964. View