Groner W, Winkelmann JW, Harris AG, Ince C, Messmer K, Nadeau RGOrthogonal polarization spectral imaging: A new method for study of the microcirculation. Nat Med 5: 1209-1212

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Nature Medicine (Impact Factor: 27.36). 11/1999; 5(10):1209-12. DOI: 10.1038/13529
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    • "" Direct techniques to observe the microcirculation. " In vivo microscopy of the microcirculation has been adapted to the clinical setting since the introduction of different generations of handheld cameras [53] [54]. The technique is based upon the visualization of red blood cells due to the absorption of green light by hemoglobin. "
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    • "Another example of an alternative advance is the use of orthogonal polarization spectral (OPS) imaging to assess the microcirculatory changes in mucosal surfaces during malaria infection [32]. The clear images of sublingual and rectal mucosa generated by the OPS device allowed for the first time the visualization in vivo of microvessel obstruction by IE in adult patients with severe malaria, confirming the evidence derived from pathological studies of fatal cases [33]. "
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    • "The microscopic techniques Orthogonal Polarization Spectral (OPS) imaging [1] and is successor Sidestream Dark Field (SDF) imaging [2] enable visualization of the microcirculation. The technique is available as a hand held device. "
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    ABSTRACT: Background Since analysis of Sidestream Dark Field images still requires subjective interpretation, we wanted to determine intra-observer repeatability and to estimate the correlation between different evaluation methods. Methods Fifty-four Sidestream Dark Field videos were analyzed twice by the same blinded observer using validated software. Vessels were detected, generating the parameter Total Vessel Density (TVD), and flow was determined by (i) classifying each vessel separately, generating the parameters Perfused Vessel Density (PVD) and Proportion of Perfused Vessels (PPV), and by (ii) the “Boerma” method, generating a Microvascular Flow Index (MFI) by quadrants. Results Intraclass Correlation Coefficients (ICCs) were above 0.9 for TVD and above 0.8 for PDV and PPV. MFIby quadrants had the lowest reliability (ICC = 0.52 for capillaries and ICC = 0.59 for all vessels), significantly lower than for PVD (ICC = 0.89, p < 0.001 for capillaries and ICC = 0.90, p < 0.001 for all vessels) and PPV (ICC = 0.82, p = 0.003 for capillaries and ICC = 0.83, p = 0.01 for all vessels). Correlation coefficient (r) between PPV and MFIby quadrants corrected for measurement error was 0.39 (0.10 – 0.64) for capillaries and 1.01 (0.85 – 1.16) for all vessels. Conclusions Intra-observer reliability for full evaluation of Sidestream Dark Field images was good for vessel detection and for flow classification but significantly poorer for the faster “Boerma” method. Furthermore, the Boerma method is likely to estimate different aspects of capillary flow than do the standard methods.
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