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. 2013 Apr;208(4):282.e1-7.
doi: 10.1016/j.ajog.2013.01.025. Epub 2013 Jan 17.

Monitoring vaginal epithelial thickness changes noninvasively in sheep using optical coherence tomography

Kathleen L Vincent  1 , Gracie Vargas, Jingna Wei, Nigel Bourne, Massoud Motamedi
Affiliations

Monitoring vaginal epithelial thickness changes noninvasively in sheep using optical coherence tomography

Kathleen L Vincent et al. Am J Obstet Gynecol. 2013 Apr.

Abstract

Objective: High-resolution optical coherence tomography can be used noninvasively to evaluate vaginal morphologic features, including epithelial thickness, to assess this protective barrier in transmission of sexually transmitted infections and to monitor tissue response to topical medications and hormonal fluctuations. We examined the use of optical coherence tomography to measure epithelial thickness noninvasively before and after topical treatment with a drug that causes epithelial thinning.

Study design: Twelve female sheep were treated with intravaginal placebo (n = 4) or nonoxynol-9 (n = 8). Vaginal optical coherence tomography images were obtained before and 24 hours after treatment. Four sheep in the nonoxynol-9 group were also examined on days 3 and 7. Vaginal biopsies were obtained on the last examination day. Epithelial thickness was measured in optical coherence tomography images and in hematoxylin and eosin-stained histologic sections from biopsies. Statistical analysis was performed using analyses of variance (significance P < .05).

Results: Baseline optical coherence tomography epithelial thickness measurements were similar (85 ± 19 μm placebo, 78 ± 20 μm nonoxynol-9; P = .52). Epithelial thinning was significant after nonoxynol-9 (32 ± 22 μm) compared with placebo (80 ± 15 μm) 24 hours after treatment (P < .0001). In the 4 nonoxynol-9-treated sheep followed for 7 days, epithelial thickness returned to baseline by day 3, and increased significantly on day 7. Epithelial thickness measurements from histology were not significantly different than optical coherence tomography (P = .98 nonoxynol-9, P = .93 hydroxyethyl cellulose).

Conclusion: Drug-induced changes in the epithelium were clearly detectable using optical coherence tomography imaging. Optical coherence tomography and histology epithelial thickness measurements were similar, validating optical coherence tomography as a noninvasive method for epithelial thickness measurement, providing an important tool for quantitative and longitudinal monitoring of vaginal epithelial changes.

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Conflict of interest statement

DISCLOSURE: The authors report no Conflict of Interest.

Figures

Figure 1
Figure 1
Vaginal OCT images (a, c) and corresponding histology from biopsy (b, d) after treatment with placebo (a, b) or nonoxynol-9 (c, d). The vaginal epithelium (arrows) is clearly defined in the representative OCT image from the placebo treated group (a); however, the epithelium is thinned after treatment with nonoxynol-9 as seen in this representative OCT image (c). The topmost dark band in the OCT images represents the glass window on the OCT probe. Corresponding histology images show similar effects after treatment (OCT scale is in mm, with each horizontal mark = 100 micrometers. Histology magnification 20x objective with bar = 100 micrometers).
Figure 2
Figure 2
Vaginal epithelial thickness before and after treatment with placebo or nonoxynol-9. Longitudinal measurement with OCT showed that vaginal epithelial thickness decreased after treatment with nonoxynol-9 (*P<0.0001). Vaginal epithelial thickness measured by OCT and histology were similar in each group. (Error bars indicate standard deviation).
Figure 3
Figure 3
The 7 day response of vaginal epithelial thickness after a single treatment with nonoxynol-9 on day 0 following baseline imaging. Vaginal epithelial thickness decreased in response to treatment, returned to baseline on day 3, and was increased on day 7. OCT thickness was similar to histology (histo) thickness on day 7. Error bars indicate standard deviation. (* p = 0.03 compared to baseline Day 0; ** p < 0.001 compared to baseline Day 0).
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