As described in previous studies, the authors used a high magnification optical imaging system (identified as EyeFlow ™) to retrieve and derive frames of images that captured the movement of red blood cells within the conjunctival microcirculation ( 5, 6). ![]() Conjunctival microcirculation imaging techniques were used to obtain conjunctival diameter and axial velocity measurements in 35 subjects with SCD, and these were compared to 10 healthy control individuals. Valeshabad and colleagues sought to investigate an association between conjunctival hemodynamic properties and albuminuria in subjects with SCD and preserved glomerular filtration rate. Renal insufficiency occurs in 4–18% of patients with SCD and leads to significant morbidity and early mortality ( 2, 3). Patients may then go on to develop nephrotic syndrome, chronic renal failure, and end stage renal disease. The most common manifestation of glomerular injury in SCD is albuminuria, occurring in 26 to 68% of adults with SCD ≥21 years of age and 4.5 to 26% of younger patients ( 4). Therefore, patients with SCD display many structural and functional renal abnormalities which are observed from the glomerulus to the papillary tip. Further, recurrent episodes of hemoglobin S polymerization and red blood cell sickling alter the rheological properties of the erythrocyte and lead to increased adhesiveness of the sickled cells to the endothelium ( 3). Red blood cells exhibit a higher propensity to sickle in the renal medulla due to its hypoxic and acidotic ambient conditions ( 2). Anemia, caused by recurring hemolysis, contributes to more chronic consequences of SCD including functional renal damage and necrosis ( 1).īecause the renal oxygen consumption rate is high, the kidney is especially sensitive to vaso-occlusion-induced hypoxia. ![]() Common characteristics of SCD include anemia, ongoing hemolysis, and a spectrum of complications impacting multiple organs. This change promotes hemoglobin S polymerization upon deoxygenation and results in the characteristic sickled-shape of red blood cells. Sickle cell disease (SCD) is an autosomal recessive disorder that arises from a single nucleotide mutation in the β–globin gene of hemoglobin.
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