Bulbar Conjunctival Microvascular Alterations in Thyroid-Associated Ophthalmopathy Patients with Different Activities

Figures & data

Figure 1. (a) Images of paranasal bulbar conjunctival microvascular network with 16× magnification. (b) One of the six regions of view of 1.20 × 0.90 mm2 to capture the movements of red blood cell clusters. (c) The fractal analysis, including D0 and Dbox, was obtained in the blue area, approximately 15.24 × 10.16 mm2

Table 1. Demographic characteristics of all enrolled subjects

	HC	Inactive TAO	Active TAO	P
N	10	10	10	NA
Gender (male, %)	5 (50.0)	6 (60.0)	5 (50.0)	.488
Age (year)	41 ± 11.2	40.1 ± 13.2	46.7 ± 9.6	.260
SBP (mmHg)	123.5 ± 16.6	125.9 ± 14.4	128.9 ± 18.5	.716
DBP (mmHg)	73.2 ± 6.6	76.6 ± 5.8	74.8 ± 9.6	.550
PBP (mmHg)	50.3 ± 9.2	49.3 ± 11.6	44.1 ± 14.3	.431
Heart rate	78.6 ± 11.6	75.1 ± 14.0	80.6 ± 10.3	.190

SBP, systolic blood pressure; DBP, diastolic blood pressure; PBP, pulse blood pressure; HC, healthy control; NA: not applicable.

Table 2. Microvascular parameters in bulbar conjunctivas

Variables	HC	Inactive TAO	Active TAO	P	Post hoc analysis P-values
					Inactive vs HC	Active vs Inactive
N	10	18	18	NA	NA	NA
Dbox	1.32 ± 0.04	1.41 ± 0.04	1.45 ± 0.07	<.001	.001	.090
D0	1.35 ± 0.03	1.41 ± 0.04	1.45 ± 0.06	<.001	.008	.040
AD (μm)	20.27 ± 1.18	22.03 ± 1.96	23.62 ± 2.62	<.001	.132	.111
BFV (μm/s)	501.63 ± 18.94	533.53 ± 32.25	567.84 ± 48.16	<.001	.117	.038
BFR (pl/s)	162.63 ± 23.13	206.59 ± 49.82	255.61 ± 75.46	<.001	.192	.060

HC, healthy control; TAO, thyroid associated-ophthalmopathy; Dbox: representing vessel density; D0: representing vessel complexity; AD: average diameter; BFV: blood flow velocity; BFR: blood flow rate.

Figure 2. Correlations between blood flow velocity and average diameter. The blood flow velocity distribution showed a positive correlation between vessel velocity and diameter in the TAO group (all r > 0.80, P < .001) and healthy control group (r > 0.60, P < .05)

Table 3. Correlations among bulbar conjunctival parameters and CAS and exophthalmos

	Dbox	D0	AD	BFV	BFR
CAS	0.475 (0.006)	0.641 (<0.001)	0.502 (0.003)	0.489 (0.004)	0.526 (0.002)
exophthalmos	0.073 (0.691)	0.299 (0.097)	0.152 (0.405)	0.136 (0.458)	0.106 (0.564)

HC, healthy control; TAO, thyroid associated-ophthalmopathy; Dbox: representing vessel density; D0: representing vessel complexity; AD: average diameter; BFV: blood flow velocity; BFR: blood flow rate.

Figure 3. The area under the receiver operator characteristic curves (AUROCs) for differentiating active TAO eyes from inactive TAO eyes of morphologic and hemodynamic microvascular parameters: Dbox (0.800), D0 (0.793), average diameter (0.787), blood flow velocity (0.798) and blood flow rate (0.800)

Figure 4. The ROC curve of the predicted value based on the multiple logistic regression analysis of all microvascular parameters in TAO patients. AUROC = 0.793