Nailfold Capillary Abnormalities in Primary Open-Angle Glaucoma: A Multisite Study

被引:30
作者
Pasquale, Louis R. [1 ,2 ]
Hanyuda, Akiko [3 ]
Ren, Ai [1 ]
Giovingo, Michael [4 ]
Greenstein, Scott H. [1 ]
Cousins, Clara [1 ]
Patrianakos, Thomas [4 ]
Tanna, Angelo P. [5 ]
Wanderling, Christopher [6 ]
Norkett, William [6 ]
Wiggs, Janey L. [1 ]
Green, Kelsey [6 ]
Kang, Jae H. [2 ]
Knepper, Paul A. [5 ,6 ]
机构
[1] Harvard Univ, Sch Med, Dept Ophthalmol, Massachusetts Eye & Ear, Boston, MA USA
[2] Harvard Univ, Brigham & Womens Hosp, Sch Med, Channing Div Network Med,Dept Med, Boston, MA 02115 USA
[3] Harvard Univ, TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
[4] John H Stroger Jr Hosp Cook Cty, Dept Ophthalmol, Chicago, IL USA
[5] Northwestern Univ, Feinberg Sch Med, Dept Ophthalmol, Chicago, IL 60611 USA
[6] Univ Illinois, Coll Med, Dept Ophthalmol & Visual Sci, Chicago, IL USA
关键词
primary open-angle glaucoma; nailfold capillary microscopy; hemorrhages; avascular zones; dilated capillaries; ENDOTHELIAL PROGENITOR CELLS; OCULAR HYPERTENSION TREATMENT; NORMAL-PRESSURE GLAUCOMA; NORMAL-TENSION GLAUCOMA; OPTIC-DISC-HEMORRHAGE; SYSTEMIC-SCLEROSIS; INTRAOCULAR-PRESSURE; NITRIC-OXIDE; COMMON VARIANTS; BLOOD-FLOW;
D O I
10.1167/iovs.15-17860
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PURPOSE. There is considerable evidence for systemic vascular dysfunction in primary openangle glaucoma (POAG). We performed nailfold capillary video microscopy to observe directly the nature of nonocular microvasculature abnormalities in POAG. METHODS. We enrolled 199 POAG patients and 124 control subjects from four sites. We used JH-1004 capillaroscopes 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 > 50 mu m, and avascular zones > 100 mu m by graders masked to case status. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) for POAG were obtained by means of logistic regression analyses that were applied to data from all cases and controls. Corresponding estimates of moderate or severe POAG versus mild POAG (based on the Hodapp-Anderson-Parrish scale) were obtained among cases only. RESULTS. After controlling for demographic factors, family history of glaucoma, systemic diseases, and use of anticoagulation and antiplatelet therapy, for each 100 nailfold capillaries assessed, all types of microvascular abnormalities were significantly associated with POAG. Specifically, the presence of any dilated capillaries (OR = 2.9; 95% CI, 1.6-5.6), avascular zones (OR = 4.4; 95% CI, 1.7-11.3) and hemorrhages (OR = 12.2; 95% CI, 5.9-25.1) were associated with POAG. Among cases, the frequency of microvascular abnormalities was not associated with glaucoma severity (P >= 0.43). CONCLUSIONS. These data provided support for nonocular capillary bed abnormalities in POAG. Comparable vascular abnormalities in the optic nerve may render it susceptible to glaucomatous damage.
引用
收藏
页码:7021 / 7028
页数:8
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