Introduction/objectives Diabetes mellitus (DM) primarily causes high blood sugar and leads to microvascular complications like diabetic retinopathy (DR), the leading cause of adult vision impairment. Early stages of DR often show no symptoms, emphasizing the need for routine eye exams. Nailfold capillaroscopy (NFC) is a non-invasive tool that could aid in detecting DM-related microvascular damage but is underused in diabetes care. The aim was to evaluate capillary changes in the nailfold of type 2 DM (T2DM) patients with or without DR. Method This cross-sectional study included 120 T2DM patients divided into two groups: group I (T2DM with DR, subdivided into four DR stages based on fundus fluorescein angiography findings) and group II (T2DM without DR). All patients underwent NFC and ophthalmological assessment. Results Group I exhibited significantly lower capillary density (P < 0.001) and higher capillary diameter (P < 0.001) compared to group II. Capillary distribution irregularities, neoangiogenesis, dilated and giant capillaries, and microhaemorrhages were significantly more prevalent in group I (P < 0.05). Among subgroups, capillary density declined (P < 0.001) and diameter increased (P < 0.001) with DR severity, being most pronounced in proliferative DR. ROC curve analysis revealed excellent predictive accuracy of capillary density (AUC = 0.937) and diameter (AUC = 0.840) for detecting DR and proliferative DR, respectively. Conclusions NFC findings, particularly reduced capillary density and increased diameter, are significantly associated with DR presence and severity. NFC is a promising tool for early detection of microvascular complications in T2DM patients. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • DM primarily causes high blood sugar and leads to microvascular complications like DR, the leading cause of adult vision impairment. NFC effectively identifies significant microvascular changes in T2DM patients with DR, including reduced capillary density, increased capillary diameter, irregular capillary distribution, neoangiogenesis, and microhemorrhages. Capillary density emerged as a reliable predictor, highlighting NFC’s potential as a non-invasive tool for early DR detection and assessment. </entry> </row> </tbody> </tgroup> </Table>

Non-rheumatologic indications of nail fold capillaroscopy: findings in type 2 diabetic patients with or without diabetic retinopathy: a cross-sectional study

期刊论文
发表日期：

2025年10月18日

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Samar Ali Abd Elghany,
Ingy Abdel Wahab Ibrahem,
Magdy Salah Moussa,
Abeer Abdel Moniem Shahba,
Haidy Ali Mohammed

摘要

Introduction/objectives

Diabetes mellitus (DM) primarily causes high blood sugar and leads to microvascular complications like diabetic retinopathy (DR), the leading cause of adult vision impairment. Early stages of DR often show no symptoms, emphasizing the need for routine eye exams. Nailfold capillaroscopy (NFC) is a non-invasive tool that could aid in detecting DM-related microvascular damage but is underused in diabetes care. The aim was to evaluate capillary changes in the nailfold of type 2 DM (T2DM) patients with or without DR.

Method

This cross-sectional study included 120 T2DM patients divided into two groups: group I (T2DM with DR, subdivided into four DR stages based on fundus fluorescein angiography findings) and group II (T2DM without DR). All patients underwent NFC and ophthalmological assessment.

Results

Group I exhibited significantly lower capillary density (P < 0.001) and higher capillary diameter (P < 0.001) compared to group II. Capillary distribution irregularities, neoangiogenesis, dilated and giant capillaries, and microhaemorrhages were significantly more prevalent in group I (P < 0.05). Among subgroups, capillary density declined (P < 0.001) and diameter increased (P < 0.001) with DR severity, being most pronounced in proliferative DR. ROC curve analysis revealed excellent predictive accuracy of capillary density (AUC = 0.937) and diameter (AUC = 0.840) for detecting DR and proliferative DR, respectively.

Conclusions

NFC findings, particularly reduced capillary density and increased diameter, are significantly associated with DR presence and severity. NFC is a promising tool for early detection of microvascular complications in T2DM patients.

Key Points

• DM primarily causes high blood sugar and leads to microvascular complications like DR, the leading cause of adult vision impairment. NFC effectively identifies significant microvascular changes in T2DM patients with DR, including reduced capillary density, increased capillary diameter, irregular capillary distribution, neoangiogenesis, and microhemorrhages. Capillary density emerged as a reliable predictor, highlighting NFC’s potential as a non-invasive tool for early DR detection and assessment.