Abnormal conjunctival microvasculature in patients with sickle cell anemia (SCA)

Theodore Wun, A. Cheung, Jeanna L Welborn, T. Paglieroni, Fern Tablin

Research output: Contribution to journalArticlepeer-review


Abnormal morphology of and flow in the microvasculature is a hallmark of SCA. However, objective measurements of these abnormalities has been limited. Using computer-assisted intravital microscopy, 7 adult patients with SCA were studied and compared with normal controls (n=50). Videotaped images of the bulbar conjunctival vessels were acquired using an intravital microscope mounted on a modified slit-lamp table. No ophthalmic medications were used. Coded video sequences were selected and analyzed using the program VASCAN developed in our laboratory. Subjective review of the sequences revealed characteristic obstructed comma- or curlicue-shaped small vessels and markedly reduced flow. Arterioles were poorly organized and disjointed. Venules were larger than normal: patients 83 μm (52-89 μm) [mean (range)] vs. controls 54 urn (50-60μm). Marginally perfused areas (defined as areas ' 120 urn from an arteriole) were also greater in the SCA patients: 23% (8-33%) (SCA) vs. 7% (5-10%) (controls). However, one patient with a benign clinical history had normal morphology and flow. Severe morphologic and flow abnormalities are present in the conjunctival vasculature of patients with SCA and can be quantitated with intravital microscopy. Longitudinal studies are ongoing to further define these abnormalities, and to measure in vivo blood flow changes in the bulbar conjunctivae in relation to clinical events.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
Issue number3
StatePublished - 1996

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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