The Associations of Conjunctival Vasculature and Serum Hemoglobin in the Moderate Anemia

ABSTRACT

PURPOSE: This study was conducted to determine the correlation of anemia and conjunctival vasculature on slit lamp biomicroscopy. METHODS: Through random sampling, 118 subjects who were either inpatients or outpatients in the hematology department were selected for examination. Palpebral conjunctival hue (PCH) and bulbar conjunctival blood column (BCBC) were observed by a single physician to whom the diagnosis and hemoglobin level of the patient were strictly masked. Three different threshold levels were defined for anemia <10 mg/dl, <11 mg/dl, and <12 mg/dl. RESULTS: Mean hemoglobin concentration was 10.39+/-2.9 mg/dl. Sensitivity of the BCBC and PCH for anemia was 86% and 41%, respectively. Specificity of BCBC improved with increasing hemoglobin threshold level for anemia. BCBC was significantly associated only with anemia of hemoglobin <12 mg/dl (p<0.02). PCH was significantly associated only with anemia of <11 mg/dl (p<0.05). BCBC showed a significant association with anemia sensitivity was higher and specificity was slightly less than PCH. CONCLUSIONS: It was not easy to detect moderate anemia solely on slit lamp biomicroscopic findings unless hemoglobin concentration was given. In conclusion, BCBC was useful in detecting moderate anemia than PCH.