Association of Nailfold Capillary Abnormalities With Primary Open-angle Glaucoma and Glaucomatous Visual Field Loss.

PRECIS: Nailfold capillary abnormalities are associated with primary open-angle glaucoma (POAG) and increased severity of global and central glaucomatous visual field (VF) loss. PURPOSE: The purpose of this study was to investigate whether nailfold capillary abnormalities are associated with POAG and the severity of glaucomatous VF loss. MATERIALS AND METHODS: A cross-sectional study of 83 POAG cases and 40 controls was conducted. Nailfold capillaroscopy images were assessed by masked graders for dilated capillaries >50 µm, crossed capillaries, tortuous capillaries, hemorrhages, avascular zones >100 µm, capillary density, and capillary distribution. VF loss in glaucoma cases was quantified using mean deviation and mean central pattern standard deviation (PSD) from the worst-affected eye. RESULTS: Logistic regression analyses of cases and controls showed that avascular zones [odds ratio (OR)=1.24; 95% confidence interval (CI): 1.06, 1.47; P=0.005], capillary density (OR=0.63; 95% CI: 0.46, 0.83; P<0.001), and capillary distribution (OR=7.88; 95% 95% CI: 2.53, 28.40; P=0.001) were associated with POAG. Simple linear regression analysis of cases only showed that nailfold hemorrhages were associated with mean deviation (ß=-5.10; 95% CI: -9.20, -1.01; P=0.015) and mean central PSD (ß=-4.37; 95% CI: -8.18, -0.57; P=0.025), and this remained significant in the multiple linear regressions. After controlling for demographic and clinical factors, avascular zones were associated with both mean deviation (ß=-0.76; 95% CI: -1.48, -0.04; P=0.040) and mean central PSD (ß=-0.78; 95% CI: -1.45, -0.10; P=0.024), whereas capillary distribution was only associated with mean deviation (ß=-4.67; 95% CI: -7.92, -1.43; P=0.017). CONCLUSION: Nailfold capillary abnormalities are associated with POAG as well as increased global and central vision loss.