Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany.
Lasers Surg Med. 2023 Sep;55(7):625-635. doi: 10.1002/lsm.23676. Epub 2023 Jun 2.
A clinical study to investigate the effectiveness of pulsed dye laser (PDL) versus Nd:YAG laser in the treatment of telangiectasias, spider veins and cherry angiomas. Dynamic optical coherence tomography (D-OCT) was introduced as an innovative follow-up tool for evaluation of blood flow within superficial vessels and to allow visualization of morphological changes of the vasculature in vivo. The final aim of this study was to demonstrate a possible treatment benefit comparing both laser types.
Vessel structures of 102 skin lesions were documented photographically and dermoscopically. Subsequently, lesions were imaged using optical coherence tomography before laser therapy (a), directly after the treatment (p) and after a follow-up 4-6 weeks after laser treatment. All lesions were treated using either a 595 nm PDL or a 1064 nm Nd:YAG laser. Two main vessel parameters, namely density and diameter, and their possible changes during follow-up were observed in 150/300/500 µm penetration depth using D-OCT and were subsequently compared between both treatment groups. Other analyzed vessel parameters were depth of the plexus, mean diameter, mean density, top edge of the vessel, columns, and spikes.
Both laser types are suitable options for the treatment of vascular skin lesions, with the most significant effect on cherry angiomas. PDL shows better results treating smaller vessels in upper skin regions, in comparison to Nd:YAG laser, achieving better results on deeper vessels, like spider veins. Using the applied laser settings, there was no statistically significant effect on telangiectasias.
D-OCT represents a new, noninvasive imaging method to evaluate blood flow and vessel morphology in the follow-up of telangiectasias, spider veins, and cherry angiomas, which underwent laser therapy.
一项临床研究旨在比较脉冲染料激光（PDL）和 Nd:YAG 激光治疗毛细血管扩张症、蜘蛛静脉和樱桃状血管瘤的疗效。动态光学相干断层扫描（D-OCT）作为一种创新性的随访工具，用于评估浅层血管内的血流，并可活体观察血管形态学变化。本研究的最终目的是证明两种激光类型的治疗效果。
对 102 个皮肤病变的血管结构进行了拍照和皮肤镜检查。随后，在激光治疗前（a）、治疗后即刻（p）和治疗后 4-6 周随访时，使用光学相干断层扫描对病变进行成像。所有病变均采用 595nm PDL 或 1064nm Nd:YAG 激光进行治疗。使用 D-OCT 观察两种主要血管参数（密度和直径）及其在随访过程中的可能变化，并在两组治疗之间进行比较。分析的其他血管参数包括丛深度、平均直径、平均密度、血管顶缘、柱和刺。
两种激光类型均是治疗血管性皮肤病变的有效选择，对樱桃状血管瘤的疗效最显著。PDL 在上部皮肤区域治疗较小血管时效果更好，与 Nd:YAG 激光相比，治疗较深的血管（如蜘蛛静脉）效果更好。使用所应用的激光参数，对毛细血管扩张症没有统计学上的显著影响。
D-OCT 是一种新的、非侵入性的成像方法，可用于评估接受激光治疗的毛细血管扩张症、蜘蛛静脉和樱桃状血管瘤的血流和血管形态。
