Paired Optic Nerve Microvasculature and Nailfold Capillary Measurements in Primary Open-Angle Glaucoma

Abstract

Purpose To assess microvascular beds in the optic nerve head (ONH), peripapillary tissue, and the nailfold in patients with primary open-angle glaucoma (POAG) versus controls. Methods Patients with POAG (n = 22) and controls (n = 12) underwent swept-source optical coherence tomography angiography of ophthalmic microvasculature and nailfold video capillaroscopy of the hand. The main outcomes were vessel density (VD) and blood flow of the ONH, the peripapillary and the nailfold microvasculatures. Results Patients with POAG were younger than controls (63.5 ± 9.4 vs. 69.9 ± 6.5 years, P = 0.03). Deep ONH VD and blood flow were lower in patients with POAG than controls (39.1% ± 3.5% vs. 43.8% ± 5.7%; 37.8% ± 5.3% vs. 46.0% ± 7.8%, respectively, P < 0.02 for both); similar results were observed with peripapillary VD (37.9 ± 2.6%, 43.4 ± 7.6%, respectively, P = 0.03). Nailfold capillary density and blood flow were lower in patients with POAG than controls (8.8 ± 1.0 vs. 9.8 ± 0.9 capillaries/mm; 19.9 ± 9.4 vs. 33.7 ± 9.8 pL/s, respectively; P < 0.009 for both). After adjusting for age and gender, deep ONH VD and blood flow, peripapillary VD, and nailfold capillary blood flow were lower in POAG than controls (β = −0.04, −0.07, −0.05, −13.19, respectively, P ≤ 0.046 for all). Among all participants, there were positive correlations between deep ONH and nailfold capillary blood flow (Pearson's correlation coefficient r = 0.42, P = 0.02), peripapillary and nailfold capillary density (r = 0.43, P = 0.03), and peripapillary and nailfold capillary blood flow ( r = 0.49, P = 0.01). Conclusions Patients with POAG demonstrated morphologic and hemodynamic alterations in both ophthalmic and nailfold microvascular beds compared to controls. Translational Relevance The concomitant abnormalities in nailfold capillaries and relevant ocular vascular beds in POAG suggest that the microvasculature may be a target for POAG treatment.

Vasoreactivity of the optic nerve head, nailfold, and facial skin in response to cold provocation in normal-tension glaucoma patients

“…The nailfold capillaries have been the subject of research interest since the 1970s, possibly because of their easy accessibility and involvement in Raynaud’s phenomenon [ 36 ]. Although our study used different instruments and measured different parameters that were used in previous research, our finding that the nailfold capillaries were thinner and shorter in NTG patients is consistent with previous reports that nailfold capillary abnormalities were present in glaucoma patients [ 9 , 37 – 39 ], indicating that we recruited a population of NTG patients with systemic vascular dysregulation.…”

Plasma metabolite profile for primary open-angle glaucoma in three US cohorts and the UK Biobank

“…Indeed, a review 31 reported that higher TG level was significantly associated with modest increases in IOP while another study suggests POAG patients have lower optic nerve blood flow which may be related to higher blood viscosity in these patients 34 . Furthermore, Shoji et al found reduced nail fold capillary blood velocity that correlated with altered ophthalmic hemodynamics in POAG patients 35 . Interestingly, we observed that the relationship with TGs was complex.…”

Systemic Capillary Responses to Acute Exercise in Hypertensive Seniors: Insights from a Single-Center Pilot Study

“…Exercise and drug therapy have proven effective for dysfunctional vessels during recanalization [26]. However, excessive sympathetic nervous system responses to exercise may increase the risk of cardiovascular events, including circulatory dysfunction at movement onset, cardiac sympathetic overactivity, and orthostatic dysregulation [27,28].…”