Department of Ophthalmology.
School of Optometry and Vision Science, The University of Auckland.
J Glaucoma. 2021 Jan 1;30(1):50-57. doi: 10.1097/IJG.0000000000001678.
Nailfold capillary abnormalities are associated with primary open-angle glaucoma (POAG) and increased severity of global and central glaucomatous visual field (VF) loss.
The purpose of this study was to investigate whether nailfold capillary abnormalities are associated with POAG and the severity of glaucomatous VF loss.
A cross-sectional study of 83 POAG cases and 40 controls was conducted. Nailfold capillaroscopy images were assessed by masked graders for dilated capillaries >50 μm, crossed capillaries, tortuous capillaries, hemorrhages, avascular zones >100 μm, capillary density, and capillary distribution. VF loss in glaucoma cases was quantified using mean deviation and mean central pattern standard deviation (PSD) from the worst-affected eye.
Logistic regression analyses of cases and controls showed that avascular zones [odds ratio (OR)=1.24; 95% confidence interval (CI): 1.06, 1.47; P=0.005], capillary density (OR=0.63; 95% CI: 0.46, 0.83; P<0.001), and capillary distribution (OR=7.88; 95% 95% CI: 2.53, 28.40; P=0.001) were associated with POAG. Simple linear regression analysis of cases only showed that nailfold hemorrhages were associated with mean deviation (β=-5.10; 95% CI: -9.20, -1.01; P=0.015) and mean central PSD (β=-4.37; 95% CI: -8.18, -0.57; P=0.025), and this remained significant in the multiple linear regressions. After controlling for demographic and clinical factors, avascular zones were associated with both mean deviation (β=-0.76; 95% CI: -1.48, -0.04; P=0.040) and mean central PSD (β=-0.78; 95% CI: -1.45, -0.10; P=0.024), whereas capillary distribution was only associated with mean deviation (β=-4.67; 95% CI: -7.92, -1.43; P=0.017).
Nailfold capillary abnormalities are associated with POAG as well as increased global and central vision loss.
甲襞毛细血管异常与原发性开角型青光眼（POAG）和全局及中央青光眼视野（VF）丧失的严重程度增加有关。
本研究旨在探讨甲襞毛细血管异常是否与 POAG 和青光眼 VF 丧失的严重程度有关。
进行了一项 83 例 POAG 病例和 40 例对照的横断面研究。通过盲法分级评估甲襞毛细血管镜图像，评估指标包括：>50μm 的扩张毛细血管、交叉毛细血管、扭曲毛细血管、出血、>100μm 的无血管区、毛细血管密度和毛细血管分布。使用最差眼的平均偏差和平均中央模式标准偏差（PSD）量化青光眼病例的 VF 损失。
病例和对照组的逻辑回归分析显示，无血管区（比值比 [OR]=1.24；95%置信区间 [CI]：1.06，1.47；P=0.005）、毛细血管密度（OR=0.63；95%CI：0.46，0.83；P<0.001）和毛细血管分布（OR=7.88；95%CI：2.53，28.40；P=0.001）与 POAG 相关。仅对病例进行简单线性回归分析显示，甲襞出血与平均偏差（β=-5.10；95%CI：-9.20，-1.01；P=0.015）和平均中央 PSD（β=-4.37；95%CI：-8.18，-0.57；P=0.025）相关，且这在多元线性回归中仍然显著。在控制人口统计学和临床因素后，无血管区与平均偏差（β=-0.76；95%CI：-1.48，-0.04；P=0.040）和平均中央 PSD（β=-0.78；95%CI：-1.45，-0.10；P=0.024）相关，而毛细血管分布仅与平均偏差（β=-4.67；95%CI：-7.92，-1.43；P=0.017）相关。
甲襞毛细血管异常与 POAG 以及全局和中央视力丧失有关。
