Vessel Sampling and Blood Flow Velocity Distribution With Vessel Diameter for Characterizing the Human Bulbar Conjunctival Microvasculature

Purpose: This study determined (1) how many vessels (i.e., the vessel sampling) are needed to reliably characterize the bulbar conjunctival microvasculature and (2) if characteristic information can be obtained from the distribution histogram of the blood flow velocity and vessel diameter. Methods: Functional slitlamp biomicroscope was used to image hundreds of venules per subject. The bulbar conjunctiva in five healthy human subjects was imaged on six different locations in the temporal bulbar conjunctiva. The histograms of the diameter and velocity were plotted to examine whether the distribution was normal. Standard errors were calculated from the standard deviation and vessel sample size. The ratio of the standard error of the mean over the population mean was used to determine the sample size cutoff. The velocity was plotted as a function of the vessel diameter to display the distribution of the diameter and velocity. Results: The results showed that the sampling size was approximately 15 vessels, which generated a standard error equivalent to 15% of the population mean from the total vessel population. The distributions of the diameter and velocity were not only unimodal, but also somewhat positively skewed and not normal. The blood flow velocity was related to the vessel diameter (r=0.23, P<0.05). Conclusions: This was the first study to determine the sampling size of the vessels and the distribution histogram of the blood flow velocity and vessel diameter, which may lead to a better understanding of the human microvascular system of the bulbar conjunctiva.

[1]  Chin-Shang Li,et al.  Whole blood viscosity and microvascular abnormalities in Alzheimer's Disease. , 2009, Clinical hemorheology and microcirculation.

[2]  A. Cheung,et al.  Microvascular abnormalities in the bulbar conjunctiva of patients with type 2 diabetes mellitus. , 2001, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[3]  G. Marsaglia,et al.  Evaluating Kolmogorov's distribution , 2003 .

[4]  A. Koutsiaris,et al.  Volume flow and wall shear stress quantification in the human conjunctival capillaries and post-capillary venules in vivo. , 2007, Biorheology.

[5]  S. A. Wong,et al.  Microvascular abnormalities in the bulbar conjunctiva of contact lens users. , 2012, Clinical hemorheology and microcirculation.

[6]  George W Ousler,et al.  Automated grading system for evaluation of ocular redness associated with dry eye , 2013, Clinical ophthalmology.

[7]  Delia Cabrera DeBuc,et al.  Functional slit lamp biomicroscopy for imaging bulbar conjunctival microvasculature in contact lens wearers. , 2014, Microvascular research.

[8]  M. Shahidi,et al.  Quantitative assessment of conjunctival microvascular circulation of the human eye. , 2010, Microvascular research.

[9]  A. Cheung,et al.  Evidence of Increased Inflammation and Microcirculatory Abnormalities in Patients With Type 1 Diabetes and Their Role in Microvascular Complications , 2007, Diabetes.

[10]  A. Cheung,et al.  Improvements in diabetic microangiopathy after successful simultaneous pancreas-kidney transplantation: a computer-assisted intravital microscopy study on the conjunctival microcirculation. , 1999, Transplantation.

[11]  A. Koutsiaris,et al.  Wall shear stress quantification in the human conjunctival pre-capillary arterioles in vivo. , 2013, Microvascular research.

[12]  R. Adams,et al.  Correlation of abnormal intracranial vessel velocity, measured by transcranial Doppler ultrasonography, with abnormal conjunctival vessel velocity, measured by computer-assisted intravital microscopy, in sickle cell disease. , 2001, Blood.

[13]  Chin-Shang Li,et al.  Correlation of microvascular abnormalities and endothelial dysfunction in Type-1 Diabetes Mellitus (T1DM): a real-time intravital microscopy study. , 2009, Clinical hemorheology and microcirculation.

[14]  Chin-Shang Li,et al.  Cardioprotective effect of metoprolol and enalapril in doxorubicin‐treated lymphoma patients: A prospective, parallel‐group, randomized, controlled study with 36‐month follow‐up , 2010, American journal of hematology.

[15]  A. Cheung,et al.  Alzheimer's disease: more than amyloid. , 2010, Clinical hemorheology and microcirculation.

[16]  Jennifer I. Lim,et al.  Human bulbar conjunctival hemodynamics in hemoglobin SS and SC disease , 2013, American journal of hematology.

[17]  Periklis Papavasileiou,et al.  Blood velocity pulse quantification in the human conjunctival pre-capillary arterioles. , 2010, Microvascular research.

[18]  Joshua W. Miller,et al.  Exchange transfusion therapy and its effects on real‐time microcirculation in pediatric sickle cell anemia patients , 2012, Journal of pediatric hematology/oncology.