Fig. 1.
Fig. 1. The microcirculation in the bulbar conjunctiva of the eye. / Optical magnification, × 4.5; onscreen magnification, × 125. A indicates arteriole; V, venule; H, hemosiderin deposit; S, blood sludging; BW, sacculated vessels (beaded or sausage-shaped); and BC, intermittent boxcar blood flow phenomenon. (A) A typical view of the conjunctival microcirculation of a healthy non-SCD subject to serve as reference (35 mm photograph). Note the even and orderly distribution of the normal-sized arterioles and venules and the normal presence of capillaries. (B) The steady-state conjunctival microcirculation of a patient with nonsevere SCD complications (hard copy of a frame-captured image). All the arterioles and venules in the field are wider in diameter than in non-SCD controls. The bulbar conjunctiva of this SCD patient is adequately vascularized; however, vessel distribution is disorganized and uneven, differing from the healthy non-SCD controls. In addition to blood sludging (S), the overall blood flow is sluggish and intermittent as indicated by the presence of the boxcar blood flow phenomenon (BC) in some vessels. The resolution and clarity of this frame-captured image is comparable to a 35 mm photograph (panel A). (C) The steady-state conjunctival microcirculation of another patient with nonsevere SCD complications (frame-captured image). All the vessels in this image are significantly (P < .01) wider in diameter than non-SCD control vessels, and vessel distribution is uneven. Note the unique absence of capillaries and the reduced presence of arterioles and venules in the upper left region of the figure, giving that location a blanched appearance. In addition, sacculated vessels (BW) (beaded or sausage-shaped vessel) and blood sludging (S) are present. (D) The steady-state microcirculation of a patient with severe SCD complications (frame-captured image). Hemosiderin deposits (H) are present, denoting previous extravasation of blood from damaged vessels. The venules are significantly (P < .01) wider in diameter than control vessels. In addition, blood sludging (S) and sacculated vessels (BW) are present.

The microcirculation in the bulbar conjunctiva of the eye.

Optical magnification, × 4.5; onscreen magnification, × 125. A indicates arteriole; V, venule; H, hemosiderin deposit; S, blood sludging; BW, sacculated vessels (beaded or sausage-shaped); and BC, intermittent boxcar blood flow phenomenon. (A) A typical view of the conjunctival microcirculation of a healthy non-SCD subject to serve as reference (35 mm photograph). Note the even and orderly distribution of the normal-sized arterioles and venules and the normal presence of capillaries. (B) The steady-state conjunctival microcirculation of a patient with nonsevere SCD complications (hard copy of a frame-captured image). All the arterioles and venules in the field are wider in diameter than in non-SCD controls. The bulbar conjunctiva of this SCD patient is adequately vascularized; however, vessel distribution is disorganized and uneven, differing from the healthy non-SCD controls. In addition to blood sludging (S), the overall blood flow is sluggish and intermittent as indicated by the presence of the boxcar blood flow phenomenon (BC) in some vessels. The resolution and clarity of this frame-captured image is comparable to a 35 mm photograph (panel A). (C) The steady-state conjunctival microcirculation of another patient with nonsevere SCD complications (frame-captured image). All the vessels in this image are significantly (P < .01) wider in diameter than non-SCD control vessels, and vessel distribution is uneven. Note the unique absence of capillaries and the reduced presence of arterioles and venules in the upper left region of the figure, giving that location a blanched appearance. In addition, sacculated vessels (BW) (beaded or sausage-shaped vessel) and blood sludging (S) are present. (D) The steady-state microcirculation of a patient with severe SCD complications (frame-captured image). Hemosiderin deposits (H) are present, denoting previous extravasation of blood from damaged vessels. The venules are significantly (P < .01) wider in diameter than control vessels. In addition, blood sludging (S) and sacculated vessels (BW) are present.

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