An evaluation of two novel capillaroscopy techniques in suspected scleroderma-spectrum disorders: A single-centre cross-sectional study

Parker, Matthew; Oliffe, Michael; McGill, Neil

doi:10.1080/14397595.2017.1404179

Cited by 10 publications

(10 citation statements)

References 15 publications

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“…Dermoscopy (similarly to USB microscopy) is hand-held and therefore easily portable, but requires an attached camera for image capture and is more expensive (in the order of $1000–$2000) than a USB microcope. A recent study comparing nailfold capillary photographs taken with a ‘smartphone lens’ and with a ‘smartphone dermatoscope’ to widefield microscopy [ 20 ] highlighted the potential of low-cost, portable devices for use in routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Comparison between low cost USB nailfold capillaroscopy and videocapillaroscopy: a pilot study

et al. 2020

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Objectives Universal serial bus (USB) microscopy (capillaroscopy) could provide all rheumatologists with an easy-to-use, low-cost tool to examine the nailfold capillaries to facilitate early diagnosis of SSc. The objectives of this pilot study were to examine the feasibility of acquiring and analysing images using USB microscopy and to compare results to videocapillaroscopy. Methods Videocapillaroscopy and USB microscope images were obtained from the right and left ring fingers of 20 patients with SSc and 20 healthy control subjects. In addition to generating panoramic capillary mosaics from across the whole nailbed, custom software made fully automated measurements of vessel structure including capillary width and density. The area under the receiver operating characteristic curve (AZ) was used to measure separation between the SSc and healthy control groups. Results High quality images could be generated from the USB microscope, with reconstructed USB images comparing very favourably with those obtained using videocapillaroscopy. Using USB microscope images, the receiver operating characteristic curve AZ for group separation based on mean width was 0.81 (standard error 0.120) compared with 0.81 (standard error 0.095) for the (gold standard) videocapillaroscopy. The receiver operating characteristic curve AZ for group separation using capillary density was 0.48 (standard error 0.16) for USB microscope images, compared with 0.70 (standard error 0.10) for videocapillaroscopy. Conclusion In this pilot study, USB capillaroscopy was able to discriminate between patients with SSc and controls as well as videocapillaroscopy on the basis of capillary width. This finding, together with the high-quality images obtained, highlights the potential of USB capillaroscopy as a low-cost, easily accessible clinical and research tool.

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Section: Discussionmentioning

confidence: 99%

Comparison between low cost USB nailfold capillaroscopy and videocapillaroscopy: a pilot study

et al. 2020

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“…Fortuitously, there are a number of low cost and handheld devices such as dermatoscopes and ophthalmoscopes which achieve a good visualisation of the nailfolds at around 10-20-fold magnification (see Figure 2c). A number of studies directly comparing these techniques with WSM and NVC have found a reassuring concordance [10][11][12]. In particular, although the rate of "unclassifiable" images is higher, ample diagnostically relevant findings can be elicited, even if more subtle changes can be missed.…”

Section: Handheld Devices-ophthalmoscopes Dermatoscopes Usb Microscmentioning

confidence: 91%

“…Rapidly improving technology, particularly with the availability of USB microscopes or attachments for smartphones, can already achieve similar magnification to NVC and record images. This infers that these devices are going to become more commonplace [11]. An additional advantage with the handheld devices is that they can be easier to use in patients with finger deformities and in thumbs (or even toes) which are often not visualised in other techniques, although the additional information gleaned from these is not yet of clear clinical utility.…”

Section: Handheld Devices-ophthalmoscopes Dermatoscopes Usb Microscmentioning

confidence: 99%

“…As technology rapidly advances there may become available a variety of novel techniques that allow for image acquisition. Inexpensive USB microscopes are already available as are accessory equipment allowing the digital camera of a smart phone to take diagnostically useful images [11]. Technology could also be harnessed to allow for quicker and more reproducible image assessment, as in the case of the recent publication of automated capillary counting [30].…”

Section: Combining Nfc With Other Technologiesmentioning

confidence: 99%

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The Established and Evolving Role of Nailfold Capillaroscopy in Connective-Tissue Disease

Parker¹,

McGill²

2020

Connective Tissue Disease - Current State of the Art

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Nailfold capillaroscopy (NFC) is a low-cost, non-invasive, rapid, highly specific and reproducible investigation well established in the diagnosis of systemic sclerosis and related conditions. This chapter will detail the relevant underlying scientific principles that underpin the investigation, the methods for performing NFC, the range of abnormalities that can be present and the currently available classification criteria before moving on to discuss the various established and emerging applications as relevant to the connective tissue diseases. In addition to its role in the diagnosis of SSc, highlighted by its inclusion in the most recent ACR/EULAR consensus classification criteria, NFC has been shown to predict disease activity, many organ-specific complications such as digital ulcers, pulmonary hypertension and interstitial lung disease, and even mortality. It is emerging as a useful investigation in other CTDs characterised by microvasculopathy, such as in the idiopathic inflammatory myopathies and mixed connective tissue disease, as well as being studied as a serial investigation in patients to act as a potential biomarker and measure of treatment efficacy. NFC can contribute to the earlier identification of patients with CTDs with clinically important complications and if applied accurately, therefore, can help improve outcomes in these often challenging diseases.

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“…Baseline NFC was available in 94 patients (total 687 images, median eight images per patient [interquartile range [7][8]; two patients excluded with insufficient image quality).…”

Section: Nailfold Capillaroscopy Characteristics At Baselinementioning

confidence: 99%

Nailfold capillaroscopy by smartphone-dermatoscope for connective tissue disease diagnosis in interstitial lung disease: a prospective observational study

et al. 2021

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Take home messageNailfold capillaroscopy by smartphone-dermatoscope is a safe, feasible tool that may improve the identification of connective tissue disease in interstitial lung disease further to routine clinical assessment. Methods Study design and participantsConsecutive patients attending a specialist ILD clinic were prospectively screened for inclusion ( 18August 2016 to 24 January 2018). Eligible patients were aged 18 years, with a consensus diagnosis of CTD-ILD or IIP by ILD multidisciplinary-meeting (ILD-MDM), and able to give informed consent.CTD diagnoses were defined by international criteria for systemic sclerosis ( SSc) [3], rheumatoid arthritis (RA) [9], Sjögren's syndrome [10], mixed connective tissue disease [11], idiopathic inflammatory myositis (IIM) [12], and systemic lupus erythematosus [13]. IIPs were defined by American Thoracic Society/European Respiratory Society classification criteria [1, 14]. Of eligible participants, patients meeting IPAF criteria were separately identified [15]. CTD-ILD and IPAF classifications were confirmed by specialist Rheumatologist assessment. Patients unable to provide consent or without CTD-ILD or IIP by ILD-MDM consensus were excluded. Diagnosis at follow-up was censored on 15 June 2020. Ethical approval was granted by the Sydney Local Health District human ethics committee (protocol number X16-0111 HREC/16/RPAH/137). DefinitionsTo delineate a well-defined CTD-ILD cohort for analysis, "CTD-ILD" included only participants fulfilling CTD classification criteria as specified. "Non-CTD ILD" included IIP and IPAF participants. Disease duration was defined as time from onset of symptoms to first clinic presentation.Considering IPAF criteria, participants with positive anti-tRNA synthetase autoantibodies, amyopathic disease, and no other features diagnostic of anti-synthetase syndrome were classified as IPAF. Anti-Ro52, anti-Mi2 and anti-SRP were considered as meeting serological IPAF criteria. "Unexplained vasculopathy" was defined as pulmonary hypertension (PH) on echocardiogram (systolic pulmonary arterial pressure [PAP] >35mmHg above right atrial pressure) [16] or right heart catheterisation (RHC;

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An evaluation of two novel capillaroscopy techniques in suspected scleroderma-spectrum disorders: A single-centre cross-sectional study

Abstract: New technologies, in this case utilising a smartphone camera, could help to improve accessibility to nailfold capillaroscopy, an important diagnostic tool and putative biomarker in scleroderma-spectrum disorders, whilst retaining accurate results.

Cited by 10 publications

References 15 publications

Comparison between low cost USB nailfold capillaroscopy and videocapillaroscopy: a pilot study

Comparison between low cost USB nailfold capillaroscopy and videocapillaroscopy: a pilot study

The Established and Evolving Role of Nailfold Capillaroscopy in Connective-Tissue Disease

Nailfold capillaroscopy by smartphone-dermatoscope for connective tissue disease diagnosis in interstitial lung disease: a prospective observational study

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