Optical Coherence Tomography Patterns in the Molecular Diagnosis and Treatment Response of Port Wine Capillary Malformations (Port Wine Birthmarks)

OBJECTIVES: To evaluate whether dynamic optical coherence tomography (D-OCT) vascular characteristics correlate with molecular diagnosis or laser treatment response in port wine capillary malformations. METHODS: D-OCT imaging was performed in a cross-sectional prospective of patients with clinically confirmed port wine capillary malformations. Vessel diameter was assessed using proprietary software and watershed segmentation and compared by genotype, clinical features, and treatment response. RESULTS: 47 subjects were recruited, with 173 D-OCT images which were captured without artifact and met inclusion criterion. Quantitative vascular measurements did not differ significantly between low-flow (GNAQ/GNA11) and fast-flow (EPHB4/RASA1) lesions. In contrast, vessel diameters were significantly greater with laser-resistant lesions after adjustment for confounders (p < 0.001). CONCLUSIONS: D-OCT did not show significant genotype discrimination in this cohort but might offer a potential noninvasive biomarker for predicting laser treatment outcomes. Further prospective studies with greater power are required to validate these findings and to determine the clinical relevance for laser treatment parameters in affected patients.