Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Comparison of Wide Field Nailfold Capillaroscopy and Videocapillaroscopy in the Assessment of the Microcirculation in Patients with Raynaud's Phenomenon.
Sekiyama, Juliana, Camargo, Cintia, Andrade, Luis Eduardo C., Kayser, Cristiane
Capillaroscopy is a well established method for the assessment of the microcirculation in patients with Raynaud's phenomenon (RP). Several equipments such as wide field nailfold capillaroscopy (NFC) and digital videocapillaroscopy are currently used. This study aimed to compare the different parameters evaluated by wide field NFC with those obtained by videocapillaroscopy, as well as to evaluate the reliability of both methods in the assessment of the microcirculation in patients with RP.
Fifty-six consecutive patients with primary RP (PRP; n = 14), and RP secondary to systemic sclerosis (SSc; n = 28) and undifferentiated connective tissue disease (n = 14) (three men and 53 women in total) were included. A control group of 14 healthy controls matched for sex and age was also included. Wide field NFC was performed using a stereomicroscope (Olympus - SZ40) under 1025 x magnification. The following parameters were analyzed in eight digits of the hands (excluding the thumb): number of capillaries/mm, number of enlarged loops (about four times the normal capillary width) and giant capillary loops (10 or more times the normal capillary width), number of microhaemorrhages, and vascular deletion score (score 03). NFC parameters were calculated as the average obtained in all analyzed fingers. Videocapillaroscopy was performed under 200 x magnification contact lens connected to an imaging analysis software (Videocap 8.14, DS-Medica, Italy). The following parameters were measured over 32 fields (4 fields per finger in 8 fingers, excluding the thumb): number of capillaries/mm, presence of enlarged (capillary diameter >20 mm) and giant capillaries (diameter >50 mm), microhaemorrhages, and capillary loss. Except for the number of capillaries/mm, a score based on a semiquantitative rating scale (score 03) was used for each videocapillaroscopy parameter. Intra- and inter-observer reliability was evaluated by performing both exams in 20 individuals in two different days and with two different observers, respectively. Observers were blinded about patients' clinical diagnosis.
There was a significant correlation (p<0.000) between wide field NFC and videocapillaroscopy in the comparison of all parameters: number of capillaries/mm (r=0.817), enlarged capillaries (r=0.902), giant capillaries (r=0.689), microhaemorrhages (r=0.506), and vascular deletion/capillaries loss (r=0.784). Inter- and intra-observer reliability (kappa-coefficient or intra-class correlation coefficient) was good for most parameters evaluated by wide field NFC and videocapillaroscopy.
In the present study both wide field NFC and videocapillaroscopy showed to be reproducible and reliable methods and could be equally useful for the evaluation of peripheral microangiopathy in patients with RP.
To cite this abstract, please use the following information:
Sekiyama, Juliana, Camargo, Cintia, Andrade, Luis Eduardo C., Kayser, Cristiane; Comparison of Wide Field Nailfold Capillaroscopy and Videocapillaroscopy in the Assessment of the Microcirculation in Patients with Raynaud's Phenomenon. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1457