a Department of Ophthalmology , Peking University First Hospital , Beijing , China.
b Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School , Boston , Massachusetts , USA.
Curr Eye Res. 2018 Nov;43(11):1342-1350. doi: 10.1080/02713683.2018.1496265. Epub 2018 Jul 31.
We performed nailfold capillary microscopy to explore microvasculature abnormalities in uveitis overall and uveitis stratified in various ways.
This was a cross-sectional, case-control, observational study. One hundred and seven uveitis patients and 130 control subjects were included. We used a JH-1004 capillaroscope to perform nailfold capillary video microscopy on the fourth and fifth digits of each subject's nondominant hand. Videos were evaluated for hemorrhages, dilated capillary loops > 25 µm, and avascular zones > 200 µm. Univariate analyses were used for the assessment of case-control morphological differences and multivariate analyses were performed to assess the relation between nailfold capillaroscopic findings and uveitis subgroups.
In univariate analysis, uveitis patients were more likely to have higher tortuosity ratings and reduced capillary density compared to controls (p < 0.001 for both); furthermore, dilated capillary loops, avascular zone and hemorrhages were more frequent in uveitis versus control subjects (p < 0.001 for all). Among cases, every unit increase in capillary density (vessels/mm) was associated with active uveitis (n = 72 cases) versus inactive disease (n = 35 cases; odds ratio (OR) = 1.7; (95% confidence interval (CI), 1.2-2.5) in multivariate analysis. Furthermore, the presence of any nailfold hemorrhage versus the absence of hemorrhage was more likely to be associated with posterior and panuveitis (n = 41 cases combined) compared to anterior and intermediate uveitis (n = 66 cases combined; OR = 5.8; 95% CI, 2.3-14.2). Moreover, we found a positive correlation between peripheral retinal leakage and nailfold capillaries dilation (r = 0.33; p = 0.015) that was not strictly significant based on the number of comparisons made.
Our study provides support for non-ocular capillary bed abnormalities in uveitis, with interesting correlations based on disease stage and anatomical classification.
我们通过甲襞毛细血管显微镜检查，探索了葡萄膜炎整体和以各种方式分层的葡萄膜炎的微血管异常。
这是一项横断面、病例对照、观察性研究。纳入了 107 例葡萄膜炎患者和 130 例对照者。我们使用 JH-1004 共聚焦显微镜对每个非优势手的第四和第五指进行甲襞毛细血管视频显微镜检查。评估视频中的出血、直径大于 25µm 的扩张毛细血管环和大于 200µm 的无血管区。采用单变量分析评估病例对照形态学差异，采用多变量分析评估甲襞毛细血管镜检查结果与葡萄膜炎亚组的关系。
在单变量分析中，与对照组相比，葡萄膜炎患者的弯曲度评分更高，毛细血管密度更低（均 p<0.001）；此外，与对照组相比，葡萄膜炎患者中扩张的毛细血管环、无血管区和出血更为常见（均 p<0.001）。在病例中，毛细血管密度（每毫米血管）每增加一个单位，与活动性葡萄膜炎（n=72 例）与非活动性疾病（n=35 例）相关（多变量分析中的比值比（OR）=1.7；95%置信区间（CI），1.2-2.5）。此外，与无出血相比，任何甲襞出血与后葡萄膜炎和全葡萄膜炎（共 41 例）的相关性大于前葡萄膜炎和中间葡萄膜炎（共 66 例；OR=5.8；95%CI，2.3-14.2）。此外，我们发现周边视网膜渗漏与甲襞毛细血管扩张之间存在正相关（r=0.33；p=0.015），但基于所进行的比较次数，这种相关性并不严格显著。
我们的研究为葡萄膜炎中非眼部毛细血管床异常提供了支持，并基于疾病阶段和解剖分类提供了有趣的相关性。
