A Cross-sectional Observational Study of Nailfold Capillary Morphology in Uveitis

Abstract

Purpose : We performed nailfold capillary microscopy to explore microvasculature abnormalities in uveitis overall and uveitis stratified in various ways.

Methods : 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 non-dominant hand. Videos were evaluated for hemorrhages, dilated capillary loops > 25um, and avascular zones > 200 um. Univariate analyses were used for the assessment of case-control morphological differences and multivariate analyses were performed to assess the relation between nail fold capillaroscopic findings and uveitis subgroups.

Results : 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.

Conclusions : Our study provides support for non-ocular capillary bed abnormalities in uveitis, with interesting correlations based on disease stage and anatomical classification.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

A normal capillaroscopic image of a 30-year-old healthy female without uveitis.

 

Nailfold Microvascular Morphology in Uveitis Patients Stratified by Disease Features