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: This was a cross-sectional, case–control, observational study. 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 nondominant hand. Videos were evaluated for hemorrhages, dilated capillary loops > 25 µm, and avascular zones > 200 µm. Univariate analyses were used for the assessment of case–control morphological differences and multivariate analyses were performed to assess the relation between nailfold 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.

KEYWORDS:

• Uveitis
• nailfold capillary microscopy
• hemorrhages
• avascular zones
• dilated capillaries

Acknowledgments

We express our greatest gratitude to all the participants in this study. We also acknowledged Xueying Li, Jiantong Du and Jie Liu for providing statistical support. All persons give permission to be acknowledged.

Disclosure of interest

No disclosure of interest.

Competing interests

The authors declare that they have no competing interests.

Author Contributions

Professor L.Y. and Professor L.R.P. as corresponding authors, were responsible for project design and funding. Professor L.R.P. and L.Y. revised the article. X.L.C, X.Y.Y, Y.C, C.Y.G, J.Z, and X.R. were responsible for subjects collection. X.L.C, and X.R. took nailfold capillary pictures and performed the reading of pictures. X.L.C, and X.Y. L attributed to data analysis, X.L.C was the major contributor in writing the manuscript. All authors contributed to the scientific discussions, they also read and approved the final manuscript.

Additional information

Funding

This work was supported by National Natural Science Foundation of China (Grant No. 81470650 and No. 81670841) and Natural Science Foundation of Beijing (Grant No.7172218).