Nailfold capillaroscopy shows promise in predicting ROP in premature infants

Assessing nailfold microvascular density during the first month of life could serve as a promising non-invasive biomarker for identifying premature infants at the highest risk of developing retinopathy of prematurity (ROP) even before it can be detected through traditional eye exams, according to a study.

The study, conducted on a cohort of 32 infants born before 33 weeks of gestation, involved capturing 1386 nailfold capillary network images of the middle fingers of each hand within the first month of life. Among these infants, 25 had paired data collected at 2-week intervals during the same period. Using a machine-learning-based segmentation approach and a validated microvascular quantification platform called REAVER Vascular Analysis, researchers analyzed the images for metrics of peripheral microvascular density.

The results found that 56% of the entire cohort and 52% of the 2-timepoint subgroup developed ROP. The authors noted that peripheral vascular density showed a significant decrease during the first month of life.

In the paired timepoint analysis, vessel length density (VLD) was found to be significantly higher in infants who later developed ROP, compared to those who did not. A VLD cutoff of  >15,100 at either timepoint correctly identified all 3 infants who required ROP therapy.

Further analysis using a mixed effects linear regression model revealed a significant correlation between peripheral vascular density metrics and the severity of ROP.

Reference
York D, Falciglia GH, Managlia E, et al. Nailfold Capillaroscopy: A Promising Non-invasive Approach to Predict Retinopathy of Prematurity. J Pediatr. 2023;113478. doi: 10.1016/j.jpeds.2023.113478. Epub ahead of print. PMID: 37182664.