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...
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Press of International Journal of Ophthalmology (IJO PRESS)
2025-06-01
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| Online Access: | http://ies.ijo.cn/en_publish/2025/6/20250620.pdf |
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| 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 |
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