Park Hae-Young Lopilly, Park Sung-Hwan, Oh Yong-Seog, Park Chan Kee
Department of Ophthalmology and Visual Science, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Arch Ophthalmol. 2011 Oct;129(10):1299-304. doi: 10.1001/archophthalmol.2011.249.
To examine the characteristics of nailfold capillary changes in patients with glaucoma and to analyze their possible relationship to other clinical characteristics of glaucoma.
One hundred eight glaucoma patients and 38 control patients were enrolled in the study. Eighty-six patients were classified as having normal tension glaucoma and 22 patients as having primary open-angle glaucoma. All patients underwent a complete ophthalmic examination and then a physical examination (in the rheumatology department) and were questioned regarding a history of systemic symptoms. Nailfold capillaroscopy was performed, and the results were analyzed by a single observer in a masked manner. Both the χ(2) test and multivariate logistic regression analysis were performed to determine which ocular characteristics were associated with the findings of nailfold capillaroscopy.
In the glaucoma patients, 55.6% showed dilated vessels, 35.2% showed loss of capillaries, and 19.4% showed nail bed hemorrhages by nailfold capillaroscopy. Disc hemorrhage was significantly associated with avascular area (odds ratio, 11.13; P < .001) and nail bed hemorrhage (81.59; P < .001). By multivariate logistic regression analysis, avascular area and nail bed hemorrhage continued to be independently associated with the presence of disc hemorrhages in glaucoma patients. No significant differences of association were found between patients having normal tension glaucoma and those having primary open-angle glaucoma.
Nailfold capillaroscopy may give valuable information about some features of patients with glaucoma. Nail bed hemorrhage and loss of nail capillaries were strongly associated with the presence of optic disc hemorrhage, and the association was stronger with nail bed hemorrhage. No differences were observed between patients with normal tension glaucoma and patients with primary open-angle glaucoma.
研究青光眼患者甲襞毛细血管变化的特征，并分析其与青光眼其他临床特征之间的可能关系。
本研究纳入了108例青光眼患者和38例对照患者。86例患者被归类为正常眼压性青光眼，22例患者为原发性开角型青光眼。所有患者均接受了全面的眼科检查，然后进行了体格检查（在风湿科），并询问了全身症状史。进行了甲襞毛细血管镜检查，结果由一名观察者以盲法进行分析。采用χ²检验和多因素logistic回归分析来确定哪些眼部特征与甲襞毛细血管镜检查结果相关。
在青光眼患者中，甲襞毛细血管镜检查显示55.6%的患者血管扩张，35.2%的患者毛细血管缺失，19.4%的患者甲床出血。视盘出血与无血管区显著相关（比值比，11.13；P <.001）和甲床出血（81.59；P <.001）。通过多因素logistic回归分析，无血管区和甲床出血在青光眼患者中继续与视盘出血的存在独立相关。正常眼压性青光眼患者和原发性开角型青光眼患者之间未发现显著的关联差异。
甲襞毛细血管镜检查可能为青光眼患者的某些特征提供有价值的信息。甲床出血和甲毛细血管缺失与视盘出血的存在密切相关，且与甲床出血的关联更强。正常眼压性青光眼患者和原发性开角型青光眼患者之间未观察到差异。
