Research links nail bed issues to glaucoma

Seoul, South Korea - A Korean clinical study suggests that nail bed vascular abnormalities are associated with optic disc hemorrhage and other manifestations of glaucoma, MedPage Today reports.

Researchers from the Catholic University of Korea found that a majority of 108 patients with glaucoma exhibited nail bed abnormalities by nailfold capillaroscopy, including dilated vessels, loss of capillaries and nail bed hemorrhage. Disc hemorrhage was associated with an 11-fold increase in the odds of nail bed avascularity and more than an 80-fold increase in the odds of nail bed hemorrhage.

The associations were similar among patients with normal-tension glaucoma and those with primary open-angle glaucoma, researchers found.

In ophthalmology, nailfold capillaroscopy is used to evaluate vasospasm in glaucoma and associated reductions in capillary circulation in the nailfold.

“These results are consistent with reports that the peripheral microcirculation in glaucoma patients is abnormal,” the authors wrote. “This is more likely to be true for glaucoma patients with optic disc hemorrhage, related to abnormal microvascular circulation of the finger, which presented as avascular areas and nail bed hemorrhages on the nailfold capillaroscopy. This suggests that glaucoma patients with optic disc hemorrhage have considerable peripheral vascular insufficiency. It also adds weight to the hypothesis that the pathogenesis of disc hemorrhage could be of vascular origin.”

In the future, the authors wrote, it may be possible to distinguish among patients with and without vascular abnormalities using techniques such as nailfold capillaroscopy, which would open new diagnostic and therapeutic options for glaucoma patients.

The study appears in the October issue of Archives of Ophthalmology.

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