Ann Clin Med Res | Volume 4, Issue 1 | Short Communication | Open Access
Anh Ly T*, Amro H and Markowitz O
Department of Ophthalmology, OptiSkin Medical, NY, USA
*Correspondance to: Thu Anh Ly
Fulltext PDFBackground and Objectives: There are multiple devices in the market for Radiofrequency (RF) microneedling, and prior studies have evaluated changes in vasculature and formation of microchannels with these technologies. This prospective study utilizes both Optical Coherence Tomography (OCT), and a new technology, Line-Field Optical Coherence Tomography (LCOCT), to evaluate changes in vascularity and microchannel formation following RF-microneedling treatments. Study Design/Materials and Method: In a prospective study, healthy adults presenting with wrinkles (n=8), melasma (n=2), and/or acne scars (n=1) received up to three RF microneedling facial treatments, with a novel applicator utilizing ultra-thin microneedles inserted at up to three depths with a single insertion, at 6-week intervals with varying follow-up visits. These patients were scanned and analyzed before and after treatment using dermoscopy, OCT, and/or LC-OCT imaging. In this study, we also included LC-OCT imaging in a subgroup of two patients to further evaluate vascular changes. Results: Eleven subjects (1 Male/10 Female), aged 55 ± 17 years (range 25-79) with Fitzpatrick Skin Types II-V had at minimum one RF microneedling treatment during a three-month study period. A total of 50 RF microneedling treatments were performed. No dots on enface OCT at 100 μm were seen post RF-microneedling, but they were observed on dermoscopy images, which also visualizes skin at 60 μm to 100 μm in depth, immediately post-treatment, 24 h after and 1 week after RF-microneedling treatment. All patients had minimal downtime and no adverse side effects with treatment. We observed an overall decrease in vascularity with OCT after treatment with the 3-in-1 ultrathin microneedle applicator. Vascular density was defined as the percentage of a region occupied by blood vessels in the OCT En-face images. Vascular density was measured at depths ranging from 0.05 mm to 0.5 mm. Greatest reduction in vascularity was seen at the depth of 0.5 mm. The average vascular density, at this depth, reduced from 26.3% at baseline visit to 15.1% at the follow-up visit. The statistically significant mean difference between vascular density prior to the first treatment and the latest follow-up measurement was -0.112 (-11.2%) (p=0.0043; 95% CI: -0.179, -0.044, using a paired t-test). We found an overall decrease in vasculature with LC-OCT consistent with the OCT findings. With LC-OCT’s increased cellular resolution, we were also able to visualize the vessels and quantify their diameter and overall appearance. Conclusion: OCT analysis showed (i) patients treated with this new bipolar RF system with 3-in-1 ultrathin microneedles applicator had an overall decrease in vascular density and (ii) like previous studies, no dots on enface OCT at 100 μm were seen post RF microneedling but were observed on dermoscopy images. We propose the use of both OCT and LC-OCT for vascular changes with RF microneedling treatments in future studies to not only follow overall trends but also to visualize and quantify the actual vessels in 3-D. We also propose further studies on microchannel formation at increased depths and utilizing better cellular resolution technology, such as reflectance confocal microscopy or LC-OCT (at 100 μm), to further study microchannel structural properties and persistence.
Anh Ly T, Amro H, Markowitz O. Vascular Density Changes after Treatment with a Bipolar Radiofrequency System Incorporating a Novel Applicator with the Thinnest Array of Microneedles. Ann Clin Med Res. 2023;4(1):1069..