Nailfold Capillaroscopy: A Promising, Noninvasive Approach to Predict Retinopathy of Prematurity

Area of Science:

• Neonatal ophthalmology
• Vascular biology
• Medical imaging analysis

Background:

• Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
• Early detection and intervention are crucial for managing ROP.
• Current methods for ROP prediction may not be sufficiently sensitive or timely.

Purpose of the Study:

• To investigate the potential of nailfold capillaroscopy to noninvasively detect dysregulated retinal angiogenesis.
• To determine if nailfold microvascular density can predict the development of ROP in premature infants.
• To establish nailfold capillaroscopy as an early biomarker for ROP risk.

Main Methods:

• A cohort of 32 premature infants (<33 weeks gestation) underwent nailfold capillary network imaging.
• Machine learning and a validated platform (REAVER) analyzed microvascular density from images taken in the first month of life.
• Vascular metrics were correlated with the subsequent development and severity of ROP.

Main Results:

• 18 of 32 infants developed ROP.
• Infants who developed ROP had significantly greater vessel length density at both time points compared to those who did not (P < .001).
• A vessel length density cutoff >15,100 μm/mm² at T1 or T2 accurately identified infants requiring ROP therapy.

Conclusions:

• Nailfold microvascular density is a promising, noninvasive biomarker for identifying premature infants at high risk for ROP.
• This method allows for risk assessment before ROP is detectable via eye examination.
• Nailfold capillaroscopy offers a novel approach for early ROP risk stratification.