Abstract: TH-PO0870
Ocular Conjunctival Capillaroscopy Exploring Microcirculatory Changes Before and After Hemodialysis
Session Information
- Dialysis: Prescription, Physiology, and Treatment Optimization
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Barnes IV, Sylvester, Edward Hines Junior Veterans Affairs Hospital, Hines, Illinois, United States
- Gaynes, Bruce Ira, Edward Hines Junior Veterans Affairs Hospital, Hines, Illinois, United States
- Harris, Molly, Edward Hines Junior Veterans Affairs Hospital, Hines, Illinois, United States
- Li, Matthew, Edward Hines Junior Veterans Affairs Hospital, Hines, Illinois, United States
- Kim, Young June, Edward Hines Junior Veterans Affairs Hospital, Hines, Illinois, United States
- Vijayakumar, Maya, Edward Hines Junior Veterans Affairs Hospital, Hines, Illinois, United States
Background
Microvascular dysfunction and altered RBC rheology may occur during hemodialysis (HD), but real-time visualization of ocular microcirculatory dynamics remains poorly characterized. We have seen pre and post videos of patients undergoing HD develop rouleau formation (figure A) and a suspected change in hemorheologic metrics.
Methods
Conjunctival capillaroscopy videos were obtained pre/post HD. Videos were converted to TIFF frame sequences with duplicate-frame collapse and analyzed using a reproducible Python-based pipeline incorporating vessel detection overlays, kymograph generation, velocity estimation, stall fraction analysis, RBC Column Coherence Index (RCCI), Capillary Density Index (CDI), and Velocity Heterogeneity Index (VHI). Because exact vessel matching between sessions was not consistently feasible, statistical analysis was performed at the session level using all-pass vessel aggregation.
Results
The pipeline successfully generated vessel-level and session-level flow visualizations and quantitative microvascular metrics across analyzed sessions. Representative post-HD kymographs in several patients demonstrated visually appreciable alterations in RBC flow organization, including apparent increased intermittency, stall behavior, and rouleaux-like aggregation patterns (figure D vs E). However, aggregate quantitative metrics did not demonstrate statistically significant pre/post differences at the current sample size of 28. Variability likely reflects limited patient numbers, evolving vessel detection/tracking methods, and inability to ensure exact vessel matching across sessions.
Conclusion
Current quantitative findings remain exploratory; qualitative kymograph and flow-pattern changes suggest potential dialysis-associated alterations in ocular microvascular dynamics. Further patient recruitment and refinement of vessel detection and matching algorithms are ongoing.
Funding
- Veterans Affairs Support