Nailfold capillary morphology and platelet function in patients with exfoliative glaucoma

Abstract

Purpose The purpose of the present study was to evaluate the nailfold capillary morphological features in patients with exfoliative glaucoma (XFG) and compare them with those pertaining to primary open-angle glaucoma (POAG), normal controls and subjects with exfoliation syndrome (XFS). The second purpose was to investigate all parameters related to platelet function on the hemogram, including the platelet count (PLT), the mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) in patients with XFG. These parameters were subsequently compared with those belonging to normal controls, POAG and XFS subjects. Methods This case control study involved 152 consecutive patients that were examined at the Glaucoma Department of Clinic for Eye Diseases, Clinical Centre of Serbia, as the referral center for glaucoma in Serbia, between June 2016 and December 2017. Results Regarding capillaroscopic characteristics, statistically significant difference was found in capillary diameter and tortuosity between the XFG and POAG group (p = 0.050 and p = 0.035) and the XFG and NC group (p = 0.003 and p = 0.044), as well as in the distribution of capillary loops and avascular zones between the XFG and NC group (p = 0.014 and p = 0.004). The subjects with XFG had lower PLT values compared to POAG patients (p = 0.022). Conclusions In conclusion, to the best of our knowledge, this study marks the first attempt to evaluate capillary morphology as well as to investigate all parameters related to platelet function on the hemogram, in patients with newly diagnosed XFG. Our findings revealed nailfold capillary morphological vascular changes in XFG patients. The subjects with XFG had lower PLT values and a higher MPV serum parameter compared to normal controls and patients with POAG. Further research in this field should therefore aim to evaluate the consequences of the aforementioned microvascular abnormalities in patients with XFG.

Vascular parameters and endothelin-1 measurements in glaucoma patients with low- and high-tension optic disc hemorrhages

“…This lack of difference corroborates the findings of another study that reported no differences in capillaroscopy findings comparing glaucomatous patients with and without DH history 37 . This observation can be explained by the fact that the presence of glaucoma itself (regardless of the glaucoma type) is already related to NC abnormalities, as reported by several studies 22,[38][39][40] .…”

Results of Nailfold Videocapillaroscopy in Patients with Pseudoexfoliative Glaucoma

“…The mentioned alterations in vessels affected by XFS may explain many ocular and systemic vasculature changes, including central retinal vein occlusion [35], vascular ischemia of the iris [36], cerebrovascular and cardiovascular disorders, renal artery stenosis, and aortic aneurysm [37][38][39]. However, there are not many studies evaluating microcapillaries in XFS/XFG patients [9,40,41]. This study showed abnormalities in the arrangement of capillaries to be more frequent in XFS patients.…”

“…Bozic et al reported no significant differences in the capillary diameter; however, their comparison included POAG and NTG patients [62]. Maric et al observed that in the XFG group, more patients had narrow or partly narrowed capillaries [40].…”

Platelet Parameters and Their Relationships With the Thickness of the Retinal Nerve Fiber Layer and Ganglion Cell Complex in Primary Open-Angle Glaucoma

“…Several clinical studies found increased platelet aggregation ( 5 , 11 ) and elevated PDW and MPV levels in POAG ( 7 ), indicating a prothrombotic state. Maric et al ( 12 ) found higher MPV levels and nailfold capillary morphological vascular changes in patients with exfoliative glaucoma. Antiplatelet effect of antiglaucomatous eye drops was reported ( 13 ).…”