Imaging blood flow in human port-wine stain in situ and in real time using optical Doppler tomography.

BACKGROUND Optical Doppler tomography (ODT) combines laser Doppler flowmetry with optical coherence tomography to obtain high-resolution images of blood flow in human skin in situ and in real time. OBSERVATIONS We present a case in which ODT was used on a patient with a port-wine stain (PWS) birthmark to document the change of blood flow in response to laser therapy. It might be possible to use ODT blood flow measurements in situ to assist in assessing the efficacy of laser PWS therapy. If partial restoration of flow occurs immediately or shortly after laser exposure, indicative of reperfusion due to inadequate blood vessel injury, the PWS can be retreated using higher light dosages. Retreatment is continued until the measured Doppler shift is zero due to a permanent reduction in blood flow, indicative of irreversible microthrombus formation in the PWS vessels. CONCLUSIONS We have demonstrated that ODT may be used for noninvasive imaging of blood vessels in PWS skin. Moreover, ODT will potentially allow laser therapy to be optimized on an individual patient basis by providing a fast, semiquantitative evaluation of the efficacy of PWS laser therapy in situ and in real time.