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Ali Kord Valeshabad, Justin Wanek, Ruth Zelkha, Jennifer I Lim, Nicole Camardo, Bruce Ira Gaynes, Mahnaz Shahidi; Conjunctival Microvascular Hemodynamics in Sickle Cell Retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):194.
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© ARVO (1962-2015); The Authors (2016-present)
To determine alterations in bulbar conjunctival microvascular hemodynamics in sickle cell retinopathy (SCR) eyes conditional on the presence of focal macular thinning (FMT).
Spectral domain optical coherence tomography (SD-OCT) and conjunctival microcirculation imaging were performed in 23 subjects (eyes) diagnosed with SCR. Retinal thickness maps were generated from 19 raster SD-OCT B-scans centered on the fovea, and mean retinal thickness measurements were calculated in 9 Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. Eyes were assigned to one of two groups (with or without FMT) based on evaluation of the retinal thickness maps. From conjunctival microcirculation image sequences, venule diameter and axial blood velocity were measured in multiple venules in each eye by customized image analysis software. Average venule diameter and axial blood velocity values were derived for each eye.
Mean age, hematocrit, sickle cell hemoglobin type, and median retinopathy stage score did not significantly differ between the with and without FMT groups (P ≥ 0.1). Retinal thickness in the parafoveal and perifoveal temporal subfields were significantly lower in eyes with FMT as compared to eyes without FMT (P = 0.04) . Venule diameters in eyes with FMT (20 ± 5 µm; N = 12) and eyes without FMT (21 ± 4 µm; N = 11) were similar (P = 0.7). Venule axial blood velocity in eyes with FMT (0.48 ± 0.20 mm/s) was significantly lower than in eyes without FMT (0.72 ± 0.29 mm/s) (P = 0.03).
Conjunctival venular blood velocity is lower in SCR subjects with FMT compared to subjects without FMT. Assessment of conjunctival microvascular hemodynamic properties may have potential value in gauging retinal ischemia.
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