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. Oct-Dec 2017;12(4):361-367.
doi: 10.4103/jovr.jovr_238_16.

Distribution of Different Sized Ocular Surface Vessels in Diabetics and Normal Individuals

Free PMC article

Distribution of Different Sized Ocular Surface Vessels in Diabetics and Normal Individuals

Touka Banaee et al. J Ophthalmic Vis Res. .
Free PMC article

Erratum in


Purpose: To compare the distribution of different sized vessels using digital photographs of the ocular surface of diabetic and normal individuals.

Methods: In this cross-sectional study, red-free conjunctival photographs of diabetic and normal individuals, aged 30-60 years, were taken under defined conditions and analyzed using a Radon transform-based algorithm for vascular segmentation. The image areas occupied by vessels (AOV) of different diameters were calculated. The main outcome measure was the distribution curve of mean AOV of different sized vessels. Secondary outcome measures included total AOV and standard deviation (SD) of AOV of different sized vessels.

Results: Two hundred and sixty-eight diabetic patients and 297 normal (control) individuals were included, differing in age (45.50 ± 5.19 vs. 40.38 ± 6.19 years, P < 0.001), systolic (126.37 ± 20.25 vs. 119.21 ± 15.81 mmHg, P < 0.001) and diastolic (78.14 ± 14.21 vs. 67.54 ± 11.46 mmHg, P < 0.001) blood pressures. The distribution curves of mean AOV differed between patients and controls (smaller AOV for larger vessels in patients; P < 0.001) as well as between patients without retinopathy and those with non-proliferative diabetic retinopathy (NPDR); with larger AOV for smaller vessels in NPDR (P < 0.001). Controlling for the effect of confounders, patients had a smaller total AOV, larger total SD of AOV, and a more skewed distribution curve of vessels compared to controls.

Conclusion: Presence of diabetes mellitus is associated with contraction of larger vessels in the conjunctiva. Smaller vessels dilate with diabetic retinopathy. These findings may be useful in the photographic screening of diabetes mellitus and retinopathy.

Keywords: Computer-assisted Image Processing; Conjunctiva; Diabetes Mellitus Type 2; Eye.

Conflict of interest statement

There are no conflicts of interest.


Figure 1
Figure 1
Distribution curve of mean area occupied by vessels (AOV) of different pixels in normal individuals and diabetic patients.
Figure 2
Figure 2
Distribution curve of mean areas occupied by vessels (AOV) of different pixels in diabetic patients with different stages of diabetic retinopathy (groups 1, 2, and 3).

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