THE VALUE OF LIGHT-REFLECTION RHEOGRAPHY FOR THE DIAGNOSIS OF SUPERFICIAL VENOUS INSUFFICIENCY - A STUDY IN PATIENTS WITH PRIMARY VARICOSE-VEINS AND IN WORKERS WITH A STANDING OCCUPATION

Objective: To study the value of light reflection rheography (LRR) as a diagnostic tool in subjects with varicose veins and venous insuffici ency. Design: A prospective study comparing patients and workers with an occupation necessitating standing. Setting: Departments of Dermatol ogy and Vascular Surgery, University Hospital VU, Amsterdam. The Nethe rlands and several manufacturing plants throughout the country. Subjec ts: Group I: 123 patients (168 legs) with a history of primary varicos e veins attending the outpatient clinic; Group II: 374 male workers (7 48 legs) with an occupation necessitating standing. Methods: A questio nnaire on venous disorders was administered, followed by clinical inve stigation, continuous-wave (c/w) Doppler ultrasound and LRR examinatio n. LRR measurements were performed above the medial malleolus. A refil ling time of at least 25 s after 10 dorsiflexions at the ankle was con sidered normal. In the case of shorter refilling times the procedure w as repeated with a tourniquet above the probe. Normalization of the re filling time indicates an incompetent superficial venous system and a normal deep system. If there was no change we concluded. deep venous i nsufficiency was present. Furthermore, in group I, duplex investigatio n of the venous system was performed. Main outcome measures: The diagn ostic conclusions of the LRR measurements were compared with the diagn osis based on duplex investigation (group I) and clinical examination combined with c/w Doppler investigation (group II). Results: Group I: duplex investigation showed 156 cases of superficial venous insufficie ncy; LRR, 33. Sensitivity of LRR: 20%. Group II: Clinical and c/w Dopp ler examination showed 189 cases of superficial venous reflux; LRR, 29 . Sensitivity of LRR: 7%. Conclusion: LRR has no apparent additive val ue in diagnosing superficial varicose veins in patients with a history of primary varicosities nor in screening a population for the presenc e of venous insufficiency.