Use of Optical Coherence Tomography (OCT) in Assessment of Diabetic Skin Wound Characteristics and Blood Flow

Published:October 09, 2022DOI:


      Optical coherence tomography allows for various measurements of skin but the utility of the device in determining properties of normal and wounded skin in diabetic patients is unknown. This single-site, non-randomized, observational study used an optical coherence tomography device to acquire skin images at 1305 nm, creating real-time image of 17 patient's skin and wounds 1 to 2 mm under the skin surface. Vertical B-scan, en-face and 3-D images were produced to calculate surface and dermal-epidermal junction roughness, the optical attenuation coefficient, a measure of light absorption and scattering, and blood flow metrics. In subjects with diabetes there was an increase in both the Ra (p < .02) and Rz (p < .001) of the wounded versus the control skin. In subjects without diabetes, there was an increase in both the Ra (p < .001) and Rz (p < .03) values of the wounded versus the control skin. At a depth of 0.6 mm across all subjects, there was an average decrease in blood flow of 63% from control to wounded skin. In subjects with diabetes, this decrease was 76%. In subjects without diabetes the decrease was 55%. The change in vasculature between control and wounded skin was associated with a p < .005. There was an increase in the Ra and Rz values and a decrease in blood flow between the wounded skin and control. The device determined a difference in the Ra and Rz values of both diabetic and healthy subjects’ skin and a more pronounced decrease in blood flow in the wounds of patients with diabetes as opposed to those without.

      Level of Clinical Evidence


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Yow AP
        • Srivastava R
        • Cheng J
        • Li A
        • Liu J
        • Schmetterer L
        • Tey HL
        • Wong DWK.
        Techniques and applications in skin OCT analysis.
        Adv Exp Med Biol. 2020; 1213: 149-163
        • Olsen J
        • Holmes J
        • Jemec GBE.
        Advances in optical coherence tomography in dermatology—a review.
        JBO. 2018; 23040901
        • Mamalis A
        • Ho D
        • Jagdeo J.
        Optical coherence tomography imaging of normal, chronologically aged, photoaged and photodamaged skin: a systematic review.
        Dermatol Surg. 2015; 41: 993-1005
        • Gabriele ML
        • Wollstein G
        • Ishikawa H
        • Kagemann L
        • Xu J
        • Folio LS
        • Schuman JS.
        Optical coherence tomography: history, current status, and laboratory work.
        Invest Ophthalmol Vis Sci. 2011; 52: 2425-2436
        • Terashima M
        • Kaneda H
        • Suzuki T.
        The role of optical coherence tomography in coronary intervention.
        Korean J Intern Med. 2012; 27: 1-12
        • Al-Mujaini A
        • Wali UK
        • Azeem S.
        Optical coherence tomography: clinical applications in medical practice.
        Oman Med J. 2013; 28: 86-91
        • Kislevitz M
        • Lu KB
        • Wamsley C
        • Hoopman J
        • Kenkel J
        • Akgul Y.
        Novel use of non-invasive devices and microbiopsies to assess facial skin rejuvenation following laser treatment.
        Lasers Surg Med. 2020; 52: 822-830
      1. American Diabetes Association. Statistics About Diabetes | ADA. Available at: Published July 28, 2022. Accessed June 18, 2021.

        • Demirseren DD
        • Emre S
        • Akoglu G
        • Arpacı D
        • Arman A
        • Metin A
        • Cakır B.
        Relationship between skin diseases and extracutaneous complications of diabetes mellitus: clinical analysis of 750 patients.
        Am J Clin Dermatol. 2014; 15: 65-70
        • Okonkwo UA
        • DiPietro LA.
        Diabetes and wound angiogenesis.
        Int J Mol Sci. 2017; 18: 1419
        • Tsourdi E
        • Barthel A
        • Rietzsch H
        • Reichel A
        • Bornstein SR.
        Current aspects in the pathophysiology and treatment of chronic wounds in diabetes mellitus.
        Biomed Res Int. 2013; 2013e385641
        • Argarini R
        • McLaughlin RA
        • Joseph SZ
        • Naylor LH
        • Carter HH
        • Haynes A
        • Marsh CE
        • Yeap BB
        • Jansen SJ
        • Green DJ.
        Visualizing and quantifying cutaneous microvascular reactivity in humans by use of optical coherence tomography: impaired dilator function in diabetes.
        Am J Physio-Endocrinol Metabol. 2020; 319: E923-E931
        • Hussain AA
        • Themstrup L
        • Mogensen M
        • Jemec GBE.
        Optical coherence tomography imaging of the skin.
        in: Humbert P Fanian F Maibach HI Agache P Agache’s Measuring the Skin: Non-Invasive Investigations, Physiology, Normal Constants. Springer International Publishing, Cham, Switzerland2017: 493-502
        • Kislevitz M
        • Wamsley C
        • Bartels M
        • Lu KB
        • Li X
        • Pinch S
        • Hoopman J
        • Barton F
        • Kenkel J
        • Akgul Y.
        Clinical translation of Scarless 0.33-mm core microbiopsy for molecular evaluation of human skin.
        Aesthet Surg J. 2020; 41: NP1710-NP1720
        • Kislevitz M
        • Lu KB
        • Wamsley CE
        • Parsa S
        • Hoopman JE
        • Kenkel JM
        • Akgul Y.
        Bipolar fractional radiofrequency treatment of suprapatellar skin assessment using non-invasive devices and microbiopsy.
        Aesthet Surg J. 2021; 41: NP1997-NP2008
        • Deegan AJ
        • Wang W
        • Men S
        • Li Y
        • Song S
        • Xu J
        • Wang RK.
        Optical coherence tomography angiography monitors human cutaneous wound healing over time.
        Quant Imaging Med Surg. 2018; 8: 135-150
        • Maiti R
        • Gerhardt LC
        • Lee ZS
        • Byers RA
        • Woods D
        • Woods JA
        • Franklin SE
        • Lewis R
        • Matcher SJ
        • Carré MJ.
        In vivo measurement of skin surface strain and sub-surface layer deformation induced by natural tissue stretching.
        J Mech Behav Biomed Mater. 2016; 62: 556-569
        • Trojahn C
        • Dobos G
        • Richter C
        • Blume-Peytavi U
        • Kottner J.
        Measuring skin aging using optical coherence tomography in vivo: a validation study.
        J Biomed Opt. 2015; 20045003
        • Jacobi U
        • Chen M
        • Frankowski G
        • Sinkgraven R
        • Hund M
        • Rzany B
        • Sterry W
        • Lademann J.
        In vivo determination of skin surface topography using an optical 3D device.
        Skin Res Technol. 2004; 10: 207-214
        • Kislevitz M
        • Akgul Y
        • Wamsley C
        • Hoopman J
        • Kenkel J.
        Use of optical coherence tomography (OCT) in aesthetic skin assessment—a short review.
        Lasers Surg Med. 2020; 52: 699-704
        • Schuh S
        • Holmes J
        • Ulrich M
        • Themstrup L
        • Jemec GBE
        • Carvalho ND
        • Pellacani G
        • Welzel J.
        Imaging blood vessel morphology in skin: dynamic optical coherence tomography as a novel potential diagnostic tool in dermatology.
        Dermatol Ther (Heidelb). 2017; 7: 187-202
        • Icli B
        • Nabzdyk CS
        • Lujan-Hernandez J
        • Cahill M
        • Auster ME
        • Wara AKM
        • Sun X
        • Ozdemir D
        • Giatsidis G
        • Orgill DP
        • Feinberg MW.
        Regulation of impaired angiogenesis in diabetic dermal wound healing by microRNA-26a.
        J Mol Cell Cardiol. 2016; 91: 151-159
        • Beer HD
        • Longaker MT
        • Werner S.
        Reduced expression of PDGF and PDGF receptors during impaired wound healing.
        J Invest Dermatol. 1997; 109: 132-138
        • Drela E
        • Stankowska K
        • Kulwas A
        • Rość D.
        Endothelial progenitor cells in diabetic foot syndrome.
        Adv Clin Exp Med. 2012; 21: 249-254