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

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journal contribution
posted on 10.06.2016, 00:00 authored by LR Pasquale, A Hanyuda, A Ren, M Giovingo, SH Greenstein, C Cousins, T Patrianakos, AP Tanna, C Wanderling, W Norkett, JL Wiggs, K Green, JH Kang, PA Knepper
PURPOSE: There is considerable evidence for systemic vascular dysfunction in primary open-angle 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 μm, and avascular zones > 100 μm 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.


Supported by Grant R01 EY015473 (LRP) from the National Institutes of Health. The Harvard Glaucoma Center of Excellence (LRP and JLW), a Harvard Medical School Distinguished Scholar Award (LRP), the BrightFocus Foundation Grant G2011047 (PAK), the Rosemary O’Meara and Kathleen F. Connelly Memorial Funds (PAK), and the Illinois Society for the Prevention of Blindness (PAK) also supported this work. APT is supported by Research to Prevent Blindness.


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This is a copy of an article published in Investigative Ophthalmology & Visual Science © 2015 Association for Research in Vision and Ophthalmology Publications.


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