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Conjunctival Vessels in Diabetes Using Functional Slit Lamp Biomicroscopy
Jodi Hwang1, Veena Karanam1, Jianhua Wang2
1University of Miami Miller School of Medicine, Miami, FL.
Cornea
|December 17, 2020
Summary
Functional slit lamp biomicroscopy (FSLB) can detect changes in conjunctival microvessels, serving as a potential indicator for diabetes complications. This noninvasive method differentiates between diabetic patients with and without complications.
Area of Science:
- Ophthalmology
- Diabetology
- Vascular Biology
Background:
- Diabetes mellitus is a systemic disease associated with microvascular and macrovascular complications.
- Early detection of diabetes-related vascular changes is crucial for timely intervention and management.
- Current methods for assessing microvascular function in diabetes can be invasive or time-consuming.
Purpose of the Study:
- To quantify conjunctival microvessel parameters using functional slit lamp biomicroscopy (FSLB) in individuals with and without diabetes.
- To investigate whether these FSLB-derived metrics can serve as surrogate markers for diabetes-related complications.
Main Methods:
- A cross-sectional study involving 98 controls, 13 individuals with diabetes without complications (D-C), and 21 with diabetes and complications (D+C).
- Bulbar conjunctival microvessel parameters including venule diameter, length, axial velocity (Va), cross-sectional velocity (Vs), flow (Q), and branching complexity were measured using FSLB.
- Comparison of metrics between control and diabetic groups, and correlation with the number of affected organ systems in diabetic patients.
Main Results:
- Axial velocity (Va) and cross-sectional velocity (Vs) significantly differed between the groups (P = 0.025 and P = 0.031, respectively).
- Va and Vs correlated with the number of organ systems affected in diabetic patients (Va: ρ = -0.42, P = 0.016; Vs: ρ = -0.41, P = 0.021).
- FSLB metrics (Va, Vs, Q) significantly discriminated between diabetic patients with and without complications (AUC for Va = 0.81, Vs = 0.79, Q = 0.81).
Conclusions:
- Functional slit lamp biomicroscopy effectively measures bulbar conjunctival blood flow metrics.
- These metrics differ significantly between controls, diabetic patients without complications, and those with complications.
- FSLB offers a quick, accessible, and noninvasive method to estimate the burden of vascular complications in diabetes.
