# The Role of Nailfold Videocapillaroscopy (NVC) in Evaluating Ocular Diseases: Insights into Retinal, Choroidal, and Optic Nerve Pathologies

## TL;DR

This review explores how nailfold videocapillaroscopy (NVC) can reveal microvascular changes linked to eye diseases like glaucoma and diabetic retinopathy.

## Contribution

The paper introduces the potential of NVC as a non-invasive tool for assessing systemic microvascular changes in ocular diseases.

## Key findings

- NVC abnormalities in glaucoma suggest systemic hypoperfusion features like reduced capillary density and microhemorrhages.
- Central serous chorioretinopathy (CSC) is linked to capillary dilation patterns, indicating a congestive microvascular profile.
- NVC findings in diabetic retinopathy correlate with disease severity, showing reduced density and neoangiogenesis.

## Abstract

Background/Objectives: Nailfold videocapillaroscopy (NVC) is a non-invasive method for visualizing systemic micro-circulation, primarily used in rheumatology. Many ocular diseases (e.g., glaucoma, diabetic retinopathy (DR), and central serous chorioretinopathy (CSC)) involve microvascular disturbances. Since microangiopathies are often systemic, NVC findings may reflect ocular pathology. This narrative review aimed to summarize current evidence linking NVC alterations with retinal, choroidal, and optic nerve diseases. Methods: A literature search of PubMed, Scopus, and Web of Science (2000–2025) was conducted using the keywords “nailfold videocapillaroscopy,” “ocular diseases,” “retinopathy,” and “glaucoma”. Results: Most available studies were cross-sectional and exploratory. In glaucoma, NVC abnormalities suggesting systemic hypoperfusion (reduced capillary density, avascular areas, tortuosity, and microhemorrhages) were frequently reported. CSC was associated with capillary dilation patterns (megacapillaries and aneurysmal dilations), supporting a congestive rather than ischemic microvascular profile. In DR, NVC abnormalities (reduced density and neoangiogenesis) correlated with DR severity. Associations were also found for AMD and idiopathic macular telangiectasia type 2 (MacTel2, also known as IMT). However, only a limited number of prospective studies assessed diagnostic performance, and data on sensitivity, specificity, or ROC-based validation remain scarce. Conclusions: Current evidence suggests that NVC reflects systemic microvascular alterations associated with several ocular diseases. While NVC shows potential as an adjunctive tool for risk assessment and phenotyping, its diagnostic validity has not yet been established. Limitations include the predominantly observational nature of the studies, heterogeneity of methodologies, and the lack of standardized diagnostic thresholds. Prospective trials integrating NVC with ocular imaging modalities, such as OCT angiography, are needed to determine its clinical utility.