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Laser speckle contrast imaging may be useful in assessment of Raynaud phenomenon
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The use of laser speckle contrast imaging may be a useful tool in assessing Raynaud’s phenomenon in patients with systemic sclerosis, but neither objective nor subjective measurements distinguished which disease was primary, according to study results.
Twenty-five patients with early systemic sclerosis (SSc) who met either American College of Rheumatology (ACR) or LeRoy and Medsger criteria and 18 patients with primary Raynaud’s phenomenon (RP) were enrolled in the study. Primary RP was defined as at least two episodes of RP with white or blue coloring of the fingertips and pain after exposure to cold or emotional stress within 1 week after enrollment and no presence of anti-nuclear antibodies (ANA). Patients were excluded in the presence of pregnancy, surgery within the prior year or the administration of new medication for RP in the prior 2 months. Patients remained on vasodilators at a consistent dose, and no differences in age, sex, medication use or smoking were observed between groups.
Participants engaged in microvascular imaging twice at a 2-week interval. During the first examination, patients were instructed on how to complete a Raynaud Condition Score (RCS) diary for assessment after the second imaging visit. Patients’ hands were exposed to cold to induce RP prior to imaging.
At the time of imaging, infrared thermography (IRT) was performed using a Thermovision camera (FLIR Systems) and processed with CTHERM software (University of Glamorgan). Laser speckle contrast imaging (LSCI) camera (Moor Instruments FLPI) was positioned 30 cm from the hands at a 30° angle and exposed with a time constant of 1 second and exposure time of 8.2 ms. The moorFLPI Imager software (Moor Instruments FLPI) was used to conduct image analysis. Perfusion was analyzed for the dorsal aspect of the right middle fingertip, the dorsal aspect of the middle phalanx of the right middle finger and at the palmar aspect of the left middle fingertip at baseline and following cold exposure.
Close agreement was seen in the assessment digital vascular function between LSCI and IRT in patients with RP and SSc, but these did not correlate with information in the RCS diaries, according to the researchers. A lower frequency of RP flares was reported by men compared with women (median daily frequency: 0.8 vs. 1.9), and digital perfusion was higher in men. Moderate-to-high reproducibility was seen with both LSCI and IRT at the two examinations, according to the researchers. – by Shirley Pulawski
Disclosure: The researchers report the study was supported by the Raynaud’s and Scleroderma Association as part of the Dando fellowship.
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