Department of Ophthalmology, Peking University First Hospital, Beijing, China.
Acta Ophthalmol. 2020 Nov;98(7):e882-e887. doi: 10.1111/aos.14416. Epub 2020 Apr 3.
To compare the morphological characteristics of the nailfold capillaries in glaucoma patients with those in healthy subjects. To evaluate the relationship of nailfold capillary morphology with retinal thickness and retinal vessel density in patients with primary open-angle (POAG) and primary angle-closure glaucoma (PACG).
Fifty-one patients with normal-tension glaucoma, thirty-two patients with hypertension glaucoma, thirty-two PACG patients and sixty-one healthy subjects were included in this cross-sectional study. Patients with connective tissue diseases or taking anticoagulation or antiplatelet agents were excluded. Nailfold capillaroscopy, spectral-domain optical coherence tomography and optical coherence tomography angiography were used to evaluate the nailfold capillary morphology, retinal thickness and retinal vessel density, respectively.
Nailfold capillary morphological features, including lower capillary density, greater tortuosity, more dilated capillaries >50 μm and more avascular zones >100 μm, were more common in POAG and PACG patients than in control subjects (all p < 0.001). In the POAG group, nailfold vessel density was negatively correlated with ganglion cell complex (GCC) thickness (odds ratio [OR] = 0.908, p = 0.010) and radial peripapillary capillary (RPC) density (OR = 0.787, p = 0.025). Tortuosity degree was negatively associated with RPC density (OR = 0.804, p = 0.016). In the PACG group, no evident relationship between nailfold capillary morphology and retinal thickness or retinal vessel density was detected (all p > 0.05).
Nailfold capillary bed abnormalities were observed in both POAG and PACG patients. The nailfold capillary features, especially microvascular density and tortuosity degree, had a significant association with GCC thickness and RPC density in subjects with POAG but not in those with PACG.
比较青光眼患者和健康受试者甲襞毛细血管的形态特征。评估原发性开角型（POAG）和原发性闭角型青光眼（PACG）患者甲襞毛细血管形态与视网膜厚度和视网膜血管密度的关系。
本横断面研究纳入了 51 例正常眼压性青光眼患者、32 例高血压性青光眼患者、32 例 PACG 患者和 61 名健康对照者。排除患有结缔组织疾病或正在服用抗凝或抗血小板药物的患者。使用甲襞毛细血管显微镜、谱域光相干断层扫描和光相干断层扫描血管造影分别评估甲襞毛细血管形态、视网膜厚度和视网膜血管密度。
POAG 和 PACG 患者的甲襞毛细血管形态特征，包括更低的毛细血管密度、更大的迂曲度、更多>50 μm 的扩张毛细血管和更多>100 μm 的无血管区，比对照组更常见（均 p<0.001）。在 POAG 组中，甲襞血管密度与神经节细胞复合体（GCC）厚度（比值比[OR] = 0.908，p = 0.010）和放射状神经纤维层毛细血管（RPC）密度（OR = 0.787，p = 0.025）呈负相关。迂曲度与 RPC 密度呈负相关（OR = 0.804，p = 0.016）。在 PACG 组中，甲襞毛细血管形态与视网膜厚度或视网膜血管密度之间未发现明显关系（均 p>0.05）。
POAG 和 PACG 患者均存在甲襞毛细血管床异常。甲襞毛细血管特征，尤其是微血管密度和迂曲度，与 POAG 患者的 GCC 厚度和 RPC 密度有显著相关性，但与 PACG 患者无显著相关性。
