Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysis

AIM: To systematically evaluate the association between nailfold capillaroscopic findings and diabetic retinopathy (DR) and compare findings in diabetic patients with and without DR. METHODS: PubMed, Web of Science, and Embase databases were searched from inception to February 2024. The quality of t...

Full description

Saved in:
Bibliographic Details
Main Authors: Qi Yan, Shi-Si Chen, Xi-Ting Lu, Hao Chen, Chao-Ying Han, Hui-Qun Wu, Li-Li Shi
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2025-06-01
Series:International Journal of Ophthalmology
Subjects:
Online Access:http://ies.ijo.cn/en_publish/2025/6/20250620.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850153393763385344
author Qi Yan
Shi-Si Chen
Xi-Ting Lu
Hao Chen
Chao-Ying Han
Hui-Qun Wu
Li-Li Shi
author_facet Qi Yan
Shi-Si Chen
Xi-Ting Lu
Hao Chen
Chao-Ying Han
Hui-Qun Wu
Li-Li Shi
author_sort Qi Yan
collection DOAJ
description AIM: To systematically evaluate the association between nailfold capillaroscopic findings and diabetic retinopathy (DR) and compare findings in diabetic patients with and without DR. METHODS: PubMed, Web of Science, and Embase databases were searched from inception to February 2024. The quality of the included studies was evaluated using a National Institutes of Health (NIH) Quality Assessment tool for Observational Cohort and Cross Sectional Studies. Meta-analysis was conducted to compare the findings of nailfold capillaroscopy between diabetic patients with or without DR. Subgroup analysis was employed to investigate the source of heterogeneity. RESULTS: Totally 12 studies with 1349 diabetic patients were included, of which 628 had DR. The overall quality of included studies was acceptable. Patients with DR had increased arteriolar diameters [mean difference (MD): 2.68, 95% confidence interval (CI): 0.64-4.72] and a higher risk of developing nailfold capillaroscopic abnormalities, including bushy capillaries [odds ratio (OR): 2.82, 95%CI: 1.65-4.80], neoformation (OR: 4.61, 95%CI: 3.15-6.76), megacapillaries (OR: 8.37, 95%CI: 5.07-13.80), tortuosity (OR: 7.29, 95%CI: 2.76-19.22), microhemorrhages (OR: 6.16, 95%CI: 2.48-15.26), meandering capillaries (OR: 4.68, 95%CI: 1.05-20.80) and avascular areas (OR: 7.92, 95%CI: 2.68-23.38). The presence of tortuous capillary was more common in DR in India than in Turkey, while avascular area in the nailfolds was linked to DR only in India (OR: 11.28, 95%CI: 3.91-32.60). Among the nailfold capillaroscopic abnormalities, tortuosity, microhemorrhage, and meandering capillary showed no significant correlation with the severity of DR, except for avascular area (P=0.04). CONCLUSION: There are significant associations between nailfold capillaroscopic findings and the presence of DR, supporting its potential as a non-invasive technique for monitoring microvascular changes in diabetic patients. However, further research is needed to validate its utility as an early screening tool for microvascular complications in diabetes.
format Article
id doaj-art-54f20b8587e54ae090b155a2ce0129eb
institution OA Journals
issn 2222-3959
2227-4898
language English
publishDate 2025-06-01
publisher Press of International Journal of Ophthalmology (IJO PRESS)
record_format Article
series International Journal of Ophthalmology
spelling doaj-art-54f20b8587e54ae090b155a2ce0129eb2025-08-20T02:25:44ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-06-011861123113010.18240/ijo.2025.06.2020250620Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysisQi Yan0Shi-Si Chen1Xi-Ting Lu2Hao Chen3Chao-Ying Han4Hui-Qun Wu5Li-Li Shi6Li-Li Shi and Hui-Qun Wu. Nantong University, Nantong 226001, Jiangsu Province, China. lilishi8668@163.com; huiqun2001@gmail.comMedical School, Nantong University, Nantong 226001, Jiangsu Province, ChinaDepartment of Ophthalmology, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, ChinaMedical School, Nantong University, Nantong 226001, Jiangsu Province, ChinaMedical School, Nantong University, Nantong 226001, Jiangsu Province, ChinaMedical School, Nantong University, Nantong 226001, Jiangsu Province, ChinaMedical School, Nantong University, Nantong 226001, Jiangsu Province, ChinaAIM: To systematically evaluate the association between nailfold capillaroscopic findings and diabetic retinopathy (DR) and compare findings in diabetic patients with and without DR. METHODS: PubMed, Web of Science, and Embase databases were searched from inception to February 2024. The quality of the included studies was evaluated using a National Institutes of Health (NIH) Quality Assessment tool for Observational Cohort and Cross Sectional Studies. Meta-analysis was conducted to compare the findings of nailfold capillaroscopy between diabetic patients with or without DR. Subgroup analysis was employed to investigate the source of heterogeneity. RESULTS: Totally 12 studies with 1349 diabetic patients were included, of which 628 had DR. The overall quality of included studies was acceptable. Patients with DR had increased arteriolar diameters [mean difference (MD): 2.68, 95% confidence interval (CI): 0.64-4.72] and a higher risk of developing nailfold capillaroscopic abnormalities, including bushy capillaries [odds ratio (OR): 2.82, 95%CI: 1.65-4.80], neoformation (OR: 4.61, 95%CI: 3.15-6.76), megacapillaries (OR: 8.37, 95%CI: 5.07-13.80), tortuosity (OR: 7.29, 95%CI: 2.76-19.22), microhemorrhages (OR: 6.16, 95%CI: 2.48-15.26), meandering capillaries (OR: 4.68, 95%CI: 1.05-20.80) and avascular areas (OR: 7.92, 95%CI: 2.68-23.38). The presence of tortuous capillary was more common in DR in India than in Turkey, while avascular area in the nailfolds was linked to DR only in India (OR: 11.28, 95%CI: 3.91-32.60). Among the nailfold capillaroscopic abnormalities, tortuosity, microhemorrhage, and meandering capillary showed no significant correlation with the severity of DR, except for avascular area (P=0.04). CONCLUSION: There are significant associations between nailfold capillaroscopic findings and the presence of DR, supporting its potential as a non-invasive technique for monitoring microvascular changes in diabetic patients. However, further research is needed to validate its utility as an early screening tool for microvascular complications in diabetes.http://ies.ijo.cn/en_publish/2025/6/20250620.pdfdiabetic retinopathydiabetes mellitusmicrovascular changesnailfold capillaroscopy
spellingShingle Qi Yan
Shi-Si Chen
Xi-Ting Lu
Hao Chen
Chao-Ying Han
Hui-Qun Wu
Li-Li Shi
Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysis
International Journal of Ophthalmology
diabetic retinopathy
diabetes mellitus
microvascular changes
nailfold capillaroscopy
title Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysis
title_full Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysis
title_fullStr Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysis
title_full_unstemmed Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysis
title_short Association between findings in nailfold capillaroscopy and diabetic retinopathy: a systematic review and Meta-analysis
title_sort association between findings in nailfold capillaroscopy and diabetic retinopathy a systematic review and meta analysis
topic diabetic retinopathy
diabetes mellitus
microvascular changes
nailfold capillaroscopy
url http://ies.ijo.cn/en_publish/2025/6/20250620.pdf
work_keys_str_mv AT qiyan associationbetweenfindingsinnailfoldcapillaroscopyanddiabeticretinopathyasystematicreviewandmetaanalysis
AT shisichen associationbetweenfindingsinnailfoldcapillaroscopyanddiabeticretinopathyasystematicreviewandmetaanalysis
AT xitinglu associationbetweenfindingsinnailfoldcapillaroscopyanddiabeticretinopathyasystematicreviewandmetaanalysis
AT haochen associationbetweenfindingsinnailfoldcapillaroscopyanddiabeticretinopathyasystematicreviewandmetaanalysis
AT chaoyinghan associationbetweenfindingsinnailfoldcapillaroscopyanddiabeticretinopathyasystematicreviewandmetaanalysis
AT huiqunwu associationbetweenfindingsinnailfoldcapillaroscopyanddiabeticretinopathyasystematicreviewandmetaanalysis
AT lilishi associationbetweenfindingsinnailfoldcapillaroscopyanddiabeticretinopathyasystematicreviewandmetaanalysis