Nailfold capillary abnormalities in primary open-angle glaucoma: A multisite study

Louis R. Pasquale, Akiko Hanyuda, Ai Ren, Michael Giovingo, Scott H. Greenstein, Clara Cousins, Thomas Patrianakos, Angelo P. Tanna, Christopher Wanderling, William Norkett, Janey L. Wiggs, Kelsey Green, Jae H. Kang, Paul A. Knepper*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


PURPOSE. There is considerable evidence for systemic vascular dysfunction in primary openangle glaucoma (POAG). We performed nailfold capillary video microscopy to observe directly the nature of nonocular microvasculature abnormalities in POAG. METHODS. We enrolled 199 POAG patients and 124 control subjects from four sites. We used JH-1004 capillaroscopes 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 > 50 mm, and avascular zones > 100 mm by graders masked to case status. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) for POAG were obtained by means of logistic regression analyses that were applied to data from all cases and controls. Corresponding estimates of moderate or severe POAG versus mild POAG (based on the Hodapp-Anderson-Parrish scale) were obtained among cases only. RESULTS. After controlling for demographic factors, family history of glaucoma, systemic diseases, and use of anticoagulation and antiplatelet therapy, for each 100 nailfold capillaries assessed, all types of microvascular abnormalities were significantly associated with POAG. Specifically, the presence of any dilated capillaries (OR= 2.9; 95% CI, 1.6–5.6), avascular zones (OR = 4.4; 95% CI, 1.7–11.3) and hemorrhages (OR =12.2; 95% CI, 5.9–25.1) were associated with POAG. Among cases, the frequency of microvascular abnormalities was not associated with glaucoma severity (P ³ 0.43). CONCLUSIONS. These data provided support for nonocular capillary bed abnormalities in POAG. Comparable vascular abnormalities in the optic nerve may render it susceptible to glaucomatous damage.

Original languageEnglish (US)
Pages (from-to)7021-7028
Number of pages8
JournalInvestigative Ophthalmology and Visual Science
Issue number12
StatePublished - Nov 1 2015


  • Avascular zones
  • Dilated capillaries
  • Hemorrhages
  • Nailfold capillary microscopy
  • Primary open-angle glaucoma

ASJC Scopus subject areas

  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Ophthalmology


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