Is age-related macular degeneration a local manifestation of systemic disorder? Changes in nailfold capillaries at age-related macular degeneration

Ir J Med Sci. 2020 May;189(2):727-733. doi: 10.1007/s11845-019-02109-1. Epub 2019 Oct 24.

Abstract

Aims: Determining whether nailfold capillary involvement is present in patients with Age-related macular degeneration (AMD) and whether there are different nailfold capillaroscopy findings between wet and dry types.

Methods: From January 2016 to December 2017, with an initial diagnosis of AMD, 53 consecutive adult patients (AMD group) and 91 age- and sex-matched healthy individuals were studied prospectively. There was no history of any other ocular disease and other disease affecting nailfold capillaries. All subjects underwent a complete ophthalmic examination. The classified and advanced stages of wet and dry types were not included. All nailfold capillaroscopy examinations were performed by the same rheumatologist.

Results: It was found that the frequency of major capillaroscopic findings such as capillary ectasia, micro-hemorrhage, tortuosity, neo-formation, bizarre capillary, and bushy capillaries increased in the AMD group according to the normal group, but no significant relationship was found for capillary aneurysm. In dry or wet type of AMD in terms of ectasia, micro-hemorrhage, tortuosity, neo-formation, bizarre structure, bushy structure, or aneurism of nailfold capillaries, no significant correlation was found.

Conclusions: Nailfold capillaroscopy can detect microvascular changes in the nailfold capillary, in early and late stages of AMD. There were morphological changes in the nailfold capillaries of AMD patients, suggesting that there are systemic superficial microvascular changes that may be due to the systemic nature of the disease.

Keywords: Age-related macular degeneration; Nailfold capillaroscopy; Pathophysiology.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Capillaries / abnormalities*
  • Female
  • Humans
  • Macular Degeneration / etiology*
  • Macular Degeneration / pathology
  • Male
  • Microscopic Angioscopy / methods*
  • Middle Aged
  • Nails / blood supply*
  • Prospective Studies