Video Capillaroscopy Research Articles

Nailfold Capillaroscopy in Systemic Lupus Erythematosus (SLE): a Point-of-Care Tool That Parallels Disease Activity and Predicts Future Complications

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by vascular complications, endothelial cell injury with subsequent dysfunction. Nailfold video capillaroscopy (NVC) is a non-invasive and reliable point-of-care method that can be used to directly visualize microscopic digital capillaries and monitor patients. In this review, we will describe NVC’s role in assessing SLE disease activity and prognosticating risk for developing vascular complications. In SLE, qualitative NVC changes like the presence of microhemorrhages and enlarged capillaries correlate with disease activity. These abnormalities are also associated with specific autoantibody profiles (e.g., anti-phospholipid and anti-U1-RNP antibodies). Recent studies show NVC changes may increase risks of digital ulceration, pulmonary arterial hypertension, and accelerated cardiovascular disease. NVC may be used in personalized medicine as an adjunct in assessing SLE activity which may help prognosticate risk of serious complications, but more studies are needed to further delineate its role in specific SLE disease subtypes.

Capillaroscopic findings in Turkish Takayasu arteritis patients

Background/aimAbnormal capillaroscopic findings have been reported in vasculitic syndromes such as Behçet’s disease, Henoch–Schönlein purpura, and Wegener’s granulomatosis. This study was conducted to define the capillaroscopic changes in patients with Takayasu arteritis (TA).Materials and methodsWe studied 28 TA patients (27 females). The nail folds from the 2nd to 5th fingers on both hands were examined with video capillaroscopy for all. A patient was defined as having an abnormal capillaroscopic examination if more than 1 morphologic abnormality was present in at least 2 nail folds.ResultsThe median capillary density of TA patients was 9 (range: 9–11). There were no patients with capillary disorganization or avascular areas. Tortuous capillaries were detected in all patients. The other common morphological capillary abnormalities included enlarged/dilated capillaries (39.3%), branching capillaries (35.7%), and hemorrhages (32.1%). Only 1 patient had giant capillaries with early scleroderma-like pattern. Overall, there were 11 (39.3%) patients with abnormal capillaroscopic findings. There were more patients with abnormal capillaroscopic findings in the subgroup of TA patients whose upper extremity blood pressure could not be measured as compared to those whose blood pressure could be measured (66.7% vs. 26.3% patients; P = 0.04).ConclusionCapillaroscopic abnormalities are frequently seen in TA patients. We consider that abnormal capillaroscopic findings in TA patients reflect the impaired blood flow due to narrowed or occluded arteries rather than the primary capillary involvement of the disease process.

Videocapillaroscopy of nail bed in systemic scleroderma: prognostic and diagnostic value

Videocapillaroscopy (VCS) is a unique method of morphological assessment of capillaries of the nail bed which is characterized by the ease and speed of execution, plays a crucial role in the early diagnosis of systemic scleroderma (SSD). The first description of pathological capillaroscopic changes in SSD was made in 1925. Decades later, they were validated and accepted as one of the diagnostic criteria in 2013 EULAR/ACR SSD classification criteria. Data are presented about the use of VCS of the nail bed in SSD. Three sclerodermal patterns have been identified: «early», «active» and «late» which reflect the evolution of capillaroscopic changes, suggesting their correlation with the duration of the disease. Current knowledge of microvascular anomalies in SSD confirms the association of vascular changes in VCS not only with duration but also with disease activity. Expert opinion is mixed about the association of VCS results with the clinical picture and involvement of organs and systems. The rate of progression of microvascular changes can be a crucial criterion for diagnosis, and in the case of rapid dynamics of capillaroscopic SSD‑associated patterns, they can be considered as an indicator of disease activity. Normalization of capillaroscopic changes in the vessels of the nail bed was observed after treatment with immunosuppressants, transplantation of hematopoietic stem cells and the use of an endothelin receptor antagonist — bosentan. The further development of knowledge about VCS of the nail bed in SSD will facilitate a wider use of this informative, non‑invasive diagnostic tool as a reliable method for assessing disease activity, prognosis, and therapeutic response.

Imaging techniques in the diagnosis and monitoring of psoriasis.

Plaque psoriasis is a chronic, immune-mediated disease, which has a multifactorial etiopathogenesis. Practical non-invasive techniques to monitor plaque psoriasis progression and treatment are necessary. Imaging techniques available for psoriasis assessment may vary in terms of resolution, depth of penetration and visual representation. This review summarizes the current developments in the field of psoriasis non-invasive imaging techniques, such as dermoscopy, conventional ultrasound and high frequency ultrasonography (HFUS), videocapillaroscopy (VC), reflectance confocal microscopy (RCM), optical microangiography (OMAG), laser Doppler imaging (LDI), multiphoton tomography (MPT) and optical coherence tomography (OCT). The aim was to collect and analyze data concerning types, indications, advantages and disadvantages of modern imaging techniques for in vivo psoriasis assessment. We focused on two main methods, videodermoscopy and HFUS, which can be included in daily dermatologists' practice and which may assist in establishing diagnosis, as well as monitoring response to topical and/or systemic therapy of psoriasis. Dermoscopy may be useful for a first evaluation and may offer an understanding of the type and distribution of blood vessels, as well as the color of the scale and the background of the lesion. Videodermoscopy allows magnification and offers a detailed evaluation of the vessel type. The utility of HFUS consists mainly in monitoring therapy response. These methods may be comparable with virtual histopathology.

Vascular Remodeling Markers in Patients with Essential Arterial Hypertension Depending on Presence of Type 2 Diabetes Mellitus

Aim. To study some vascular remodeling markers in hypertensive patients depending on the presence of type 2 diabetes mellitus.Material and methods. The study included patients with essential hypertension 1-2 degrees of increase in blood pressure with/without type 2 diabetes (30 and 32 patients respectively). Using photoplethysmography in combination with reactive hyperemia test structural and functional markers of vascular remodeling were determined: in large vessels – stiffness index and phase shift; in microvessels – reflection index and the occlusion index. Using the computer video capillaroscopy of the nail bed the density of the capillary network at rest, after venous occlusion and after the test with reactive hyperemia was determined. ELISA was used for determining the level of humoral markers of endothelium dysfunction and vascular bed remodeling: metalloproteinase 9, metalloproteinase 9 inhibitor, E-selectin, endothelin, transforming growth factor (TGF-β1), endothelial growthfactor A.Results. In compare with hypertensive patients in hypertensive patients with type 2 diabetes significantly higher stiffness index values (11.15 [10.05; 12.35] vs 10.15 [8.83; 11.83] m/s; p=0.04) were found as well as significantly lower (p=0.00) capillary network density at rest (26.4 [24.2; 27.6] vs 35.1 [33.0; 45.0] cap/mm2; p=0.00) after the tests with reactive hyperemia (29 [24; 33.3] vs 40.0 [35.0;43.3] cap/mm2; p=0.00) and venous occlusion (32.5 [27.8; 34.5] vs 40.0 [33.0; 45.0] cap/mm2). In hypertensive patients with type 2 diabetes significantly higher levels of TFG-β1 (11648 [4117.8; 37933.8] vs 3938.5 [1808.8; 7694] pg/ml; p=0.00) and significantly lower levels of endothelin-1 (0,46 [0,29;1,3] vs 1.73 [0.63; 2.30] ng/ml; p=0.01) was detected in compare with hypertensive patients without type 2 diabetes.Conclusion. In both groups some signs of vascular remodeling were found at the level of both large arteries and microvessels (arterioles and capillaries). However, the group of hypertension + type 2 diabetes mellitus had statistically significantly more pronounced changes in arterial stiffness, capillary network density, as well as humoral markers levels of fibrosis and endothelial dysfunction.

Solid Lipid Curcumin-loaded Particles for in vivo Fluorescent Imaging in Humans: A Proof of Concept

The possibility to use oral intake of fluorescent dyes approved on humans for intravital fluorescence in vivo imaging is attractive due to its simplicity and non-invasive character. Here we investigate the potential of solid lipid curcumin particles (SLCP) for imaging of capillary permeability using fluorescence video capillaroscopy. Curcumin fluorescence corresponding to 0.7 μg/mL concentration was observed from blood plasma after oral consumption of 2 g of SLCP. However, this signal was ~15% higher than that of blood plasma intrinsic fluorescence, which was itself at least 10-fold lower than the background signal from pericapillary tissue. By comparing the optical properties and concentration to the case of intravenous injection of sodium fluorescein, we analyzed which parameters of the experiment should be optimized for using oral consumption of fluorescing compounds in intravital in vivo capillaroscopy measurements.

Dynamic evaluation of blood flow microcirculation by combined use of the laser Doppler flowmetry and high-speed videocapillaroscopy methods.

The dynamic light scattering methods are widely used in biomedical diagnostics involving evaluation of blood flow. However, there exist some difficulties in quantitative interpretation of backscattered light signals from the viewpoint of diagnostic information. This study considers the application of the high-speed videocapillaroscopy (VCS) method that provides the direct measurement of the red blood cells (RBCs) velocity into a capillary. The VCS signal presents true oscillation nature of backscattered light caused by moving RBCs. Thus, the VCS signal can be assigned as a reference one with respect to more complicated signals like in laser Doppler flowmetry (LDF). An essential correlation between blood flow velocity oscillations in a separate human capillary and the integral perfusion estimate obtained by the LDF method has been found. The observation of blood flow by the VCS method during upper arm occlusion has shown emergence of the reverse blood flow effect in capillaries that corresponds to the biological zero signal in the LDF. The reverse blood flow effect has to be taken into account in interpretation of LDF signals.

Resting nailfold capillary blood flow in primary open-angle glaucoma

Background/AimsAn altered haemodynamic profile for various ocular posterior segment capillary beds has been documented in primary open-angle glaucoma (POAG). POAG may also involve abnormal non-ocular blood flow, and the nailfold...

Solid lipid curcumin-loaded particles for in vivo fluorescent imaging in humans: a proof of concept-=SUP=-*-=/SUP=-

The possibility to use oral intake of fluorescent dyes approved on humans for intravital fluorescence in vivo imaging is attractive due to its simplicity and non-invasive character. Here we investigate the potential of solid lipid curcumin particles (SLCP) for imaging of capillary permeability using fluorescence video capillaroscopy. Curcumin fluorescence corresponding to 0.7 μg/ml concentration was observed from blood plasma after oral consumption of 2 g of SLCP. However, this signal was ~ 15% higher than that of blood plasma intrinsic fluorescence, which was itself at least 10-fold lower than the background signal from pericapillary tissue. By comparing the optical properties and concentration to the case of intravenous injection of sodium fluorescein, we analyzed which parameters of the experiment should be optimized for using oral consumption of fluorescing compounds in intravital in vivo capillaroscopy measurements.

Nailfold Capillary Morphology in Alzheimer's Disease Dementia.

Cerebrovascular disease (CVD) is highly comorbid with Alzheimer's disease (AD), yet its role is not entirely understood. Nailfold video capillaroscopy (NVC) is a noninvasive method of live imaging the capillaries near the fingernail's cuticle and may help to describe further vascular contributions to AD. To examine finger nailfold capillary morphology using NVC in subjects with AD dementia, mild cognitive impairment (MCI), and normal cognition (NC). We evaluated nailfold capillary hemorrhages, avascular zones ≥100 microns, and degree of tortuosity in 28 NC, 15 MCI, and 18 AD dementia subjects using NVC. Tortuosity was measured with a semi-quantitative rating scale. To assess the relation between nailfold capillary morphological features and diagnostic grouping, univariate and multivariable logistic regression models were fit to the data. 56% of subjects with AD dementia compared to 14% with NC and 13% with MCI displayed moderate to severe tortuosity. Greater severity of tortuosity was associated with 10.6-fold (95% confidence interval [CI]: 2.4, 46.2; p = 0.0018) and 7.4-fold (95% CI: 1.3, 41.3; p = 0.023) increased odds of AD dementia relative to NC and MCI, respectively, after adjusting for multiple covariates. Greater nailfold capillary tortuosity was found in participants with AD dementia compared to those with MCI or NC. These data provide preliminary evidence of a systemic microvasculopathy in AD that may be noninvasively and inexpensively evaluated through NVC.

Combination Antihypertensive Therapy with Perindopril and Indapamide in Patients with Essential Hypertension: Effect on Endothelial and Cognitive Markers of Vascular Improvement.

The objective of this study was to assess the impact of a single-pill combination (SPC) of perindopril/indapamide (PER/IND) at full doses (10/2.5 mg) on endothelial and cognitive function as a clinical intermediate marker of vascular improvement. This open-label, uncontrolled, observational study enrolled 30 patients (20 females and 10 males) with grade II-III uncontrolled arterial hypertension (SBP/DBP ≥160/100 mmHg) and no evidence of cerebrovascular disease. All patients underwent assessment of macro- and microvascular endothelial function parameters at baseline and after 12 months of treatment with SPC PER/IND using photoplethysmography and video capillaroscopy. Cognitive function was assessed using the Montreal Cognitive Assessment scale (MoCA). All patients (mean age 60.06 ± 10.19 years) were at high risk for cardiovascular events: mean body mass index (BMI) 31.2 ± 3.9 kg/m2, 33% diagnosed with coronary artery disease angina class I, 30% with impaired glucose tolerance, and 7% with type 2 diabetes. Impaired endothelial function was observed at the both micro- and macrovascular levels. Endothelial function parameters improved after 12-month treatment with SPC PER/IND with an increase in occlusion index from 1.4 to 1.8 (P < 0.00005) and phase shift from 5.0 to 10.8 (P < 0.00001); all values achieved levels in the normal range. Resting capillary network density (CND) increased from 44.8 to 52 cap/mm2 (P < 0.00007), and CND after a venous occlusion test increased from 55 to 61 cap/mm2 (P < 0.006). Signs of cognitive impairment were present at baseline with a mean MoCA score of 23 (normal cognitive function score ≥ 26), but improved after 12-month treatment with a mean MoCA score of 27 (P< 0.0001). Treatment was well tolerated. SPC PER/IND at full doses for 12 months improves endothelial function, structural and functional parameters of the microcirculation, as well as cognitive function in patients with arterial hypertension at high cardiovascular risk. Les Laboratoires Servier.

Image enhancement effect on inter and intra-observer reliability of nailfold capillary assessment

BackgroundNailfold capillaroscopy (NC) is a diagnostic imaging technique that is used to assess the blood capillary network in the nailfold area. NC is routinely used for patients with microcirculation problems, such as systemic sclerosis and other connective tissue diseases. Experts commonly use subjective evaluation as a reference point in images of nailfold video capillaroscopy, so it is important to reduce the inherent ambiguities in human judgment and diagnosis. Image quality is an important factor that affects measurement error and assessment time of NC images. ObjectiveIn this study, a new image enhancement technique was introduced and evaluated subjectively. MethodsIn total, 475 nailfold video capillaroscopy images from 18 healthy subjects and 41 systemic lupus erythematosus patients were used. The images were randomly divided into two sets, one each with 275 and 200. Eight independent observers who were familiar with the capillaroscopy technique participated in this study. The set of 275 images was evaluated by three observers with the forced–choice pairwise comparison method. Elliptic broken line (EBL) was used to count the number of capillaries. The intra- and inter-observer reliability of the original and enhanced images was evaluated on 200 images by five observers. ResultExcept for eight images, all observers preferred the enhanced images in the visual quality comparison method. The intra-class correlation coefficient (ICC) of intra- and inter-observer reliability increased from 0.76–0.84 to 0.82–0.89, respectively, when using the enhancement method. ConclusionBy improving the image quality, more capillary details will be visible, and an observer can document more details that may not be visible in the original image and can do so more efficiently.

In vivo optical imaging of the viable epidermis around the nailfold capillaries for the assessment of heart failure severity in humans.

Heart failure (HF) is among the socially significant diseases, involving over 2% of the adult population in the developed countries. Diagnostics of the HF severity remains complicated due to the absence of specific symptoms and objective criteria. Here, we present an indicator of the HF severity based on the imaging of tissue parameters around the nailfold capillaries. High resolution nailfold video capillaroscopy was performed to determine the perivascular zone (PZ) size around nailfold capillaries, and 2-photon tomography with fluorescence lifetime imaging was used to investigate PZ composition. We found that the size of PZ around the nailfold capillaries strongly correlates with HF severity. Further investigations using 2-photon tomography demonstrated that PZ corresponds to the border of viable epidermis and it was suggested that the PZ size variations were due to the different amounts of interstitial fluid that potentially further translates in clinically significant oedema. The obtained results allow for the development of a quantitative indicator of oedematous syndrome, which can be used in various applications to monitor the dynamics of interstitial fluid retention. We therefore suggest PZ size measured with nailfold video capillaroscopy as a novel quantitative sensitive non-invasive marker of HF severity.

Can nailfold videocapillaroscopy images be interpreted reliably by different observers? Results of an inter-reader and intra-reader exercise among rheumatologists with different experience in this field.

Nailfold videocapillaroscopy (VCP) allows non-invasive assessment of the microcirculation. Adequate training in this field is relevant for rheumatologists. There is increasing evidence of the reliability of VCP findings among different readers. Objective: To evaluate inter- and intra-reader agreement of rheumatologists to identify normal images and systemic sclerosis (SSc) patterns on VCP ("early," "active," and "late" proposed by Cutolo et al.). Thirteen rheumatologists with different experience in nailfold VCP received training to standardize reading criteria. They rated 60 VCP images from healthy and SSc patients at baseline and 4weeks later, using an electronic platform. The reading of an expert was considered the gold standard. Data were analyzed using Cohen's kappa for concordance and Student's t test and ANOVA to compare kappa means for inter-reader, intra-reader, and inter-pattern readings. Mean inter-reader and intra-reader kappa were 0.45 and 0.49, respectively, (moderate agreement). Kappa scores were higher among experienced vs inexperienced readers (inter-reader kappa 0.58 vs 0.34, p = 0.001, intra-reader kappa 0.65 vs 0.37, p = 0.01). Agreement was substantial (kappa = 0.61) for the identification of normal vs abnormal images and higher for the identification of active (0.48, p = 0.009) and late SSc patterns (0.56, p = 0.008) than for the early SSc pattern (0.35, p = 0.003). There is moderate agreement among rheumatologists for the identification of SSc videocapillaroscopy patterns (higher among experienced rheumatologists) and substantial agreement, regardless of previous experience in VCP, in the identification of normal and abnormal images. Agreement for the identification of active and late patterns is higher than for the early pattern.

The evaluation of nailfold videocapillaroscopy findings in patients with type 2 diabetes with and without diabetic retinopathy.

OBJECTIVE:Diabetes mellitus (DM) is a chronic hyperglycemic state and is associated with microvascular structural alterations. This study aimed to investigate the diameters of capillary loops and morphostructural changes using nailfold video capillaroscopy (NVC) in patients with type 2 DM with and without diabetic retinopathy (DR).METHODS:This cross-sectional, single-center study was conducted in patients with type 2 DM who were followed in outpatient clinics of ophthalmology and internal medicine. General demographic data were collected from patients. An ophthalmologist examined all patients in terms of DR. A rheumatologist blinded to the clinical data performed NVC. The diameters of apical, arterial, and venous loop of capillaries were measured, and the microvascular changes of capillaries were scored.RESULTS:In this study, 44 patients with type 2 DM with DR (47.7% males) and 20 patients with type 2 DM without DR (55% males) were included. In our study, patients with type 2 DM with DR had more frequent capillary hemorrhage, more frequent ectasia, more frequent giant capillary, and more frequent neo-angiogenesis than patients with type 2 DM without DR. However, these findings were not statistically significant.CONCLUSION:Further controlled studies with large sample size are needed to determine the characteristic NVC findings of DR in patients with type 2 DM.

Video capillaroscopy clarifies mechanism of the photoplethysmographic waveform appearance

Photoplethysmography (PPG) devices are widely used in clinical practice but the origin of PPG signal is still under debating. The classical theory assumes that the PPG waveform stems from variations of blood volume in pulsating arteries. In this research we analysed high-speed video recordings of capillaries in a fingernail bed. It was found that speed of erythrocytes in capillaries has pronounced modulation in time, which follows variations of instantaneous blood pressure in arteries. However, the mean speed significantly differs even for neighbour capillaries whereas change of the speed occurs in phase for the most of capillaries. Moreover, the light intensity remitted from the papillary dermis is also modulated at the heartbeat frequency displaying significant correlation with waveforms of the RBC speed. Obtained results can hardly be explained by the classical theory of PPG signal formation. Shallow penetrating visible light acquires modulation of erythrocytes density in the capillary bed without interacting with deeper situated pulsating arteries. Therefore, the capillary bed could serve as a distributed sensor for monitor the status of deep vessels. Better understanding of the photoplethysmography basis will result in a wider range of applications of this fast growing technology in both medical and research practice.

High-speed video capillaroscopy method for imaging and evaluation of moving red blood cells

The video capillaroscopy system with high image recording rate to resolve moving red blood cells with velocity up to 5 mm/s into a capillary is considered. Proposed procedures of the recorded video sequence processing allow evaluating spatial capillary area, capillary diameter and central line with high accuracy and reliability independently on properties of individual capillary. Two-dimensional inter frame procedure is applied to find lateral shift of neighbor images in the blood flow area with moving red blood cells and to measure directly the blood flow velocity along a capillary central line. The developed method opens new opportunities for biomedical diagnostics, particularly, due to long-time continuous monitoring of red blood cells velocity into capillary. Spatio-temporal representation of capillary blood flow is considered. Experimental results of direct measurement of blood flow velocity into separate capillary as well as capillary net are presented and discussed.

PP.20.10] ENDOTHELIAL DYSFUNCTION AND VASCULAR REMODELING IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION.

Objective: To investigate the morÐhofunctional parameters of macro- and microvessels in patients with essential arterial hypertension Design and method: 30 patients (11 men, 19 women) with essential arterial hypertension were enrolled, mean age was 57,2 ± 10,5 years with mean body mass index 28,6 ± 3,2 kg/m2., mean level of fasting glucose was 5,2 (4,8;5,5) mmol/l. All patients were investigated according to standard cardiac algorithm and underwent assessment of endothelial function using photopletismography (PPG) (Angioscan-01, Angioscan, Russia) at rest and after reactive hyperemia test. Phase shear (PS), occlusion index (OI) were estimated as marker of endothelial dysfunction, meanwhile, stiffness index SI) as well as reflection index (RI) were markers of middle vessels and micro vessels’ remodeling. Functional and structural condition of finger skin capillary network was studied with video capillaroscopy (Capillaroscan-1, New energetic technologies, Russia). Structurals parametres were identified as skin capillary network density at rest and after venous occlusion test. Moreover patients were investigated with applanation tonometry- Central aortic blood pressure (CASP) was measured. Results: We noted endothelial dysfunction of macrovessels (decrease of phase shear (PS) in combination with normal level of stiffness index (SI)) and of middle caliber arteries and microcirculatory vascular bed (MCVB) (decrease of occlusion index at the level of MCVB in combination with decreasing of skin capillary network density at rest and after tests with reactive hyperemia and venous occlusion and normal level of reflection index (RI)) in compare with healthy controls. Also patients with essential arterial hypertension had increased CASP in compare with normal range. Conclusions: Patients with essential arterial hypertension without obesity and diabetes mellitus had endothelial dysfunction of arterial vessels (from macro- to microvessels) as well as microcirculatory vascular remodeling. Our research confirmed CASP is integrative parameter that reflects endothelial dysfunction and remodeling processes of different levels of arterial bed.

101 Effect of oxygen therapy in early neotnatal life on capillary microcirculation and blood pressure in low birth weight infants

BackgroundLow birth weight (LBW) is a risk factor for adult essential hypertension, diabetes mellitus, obesity and cardiovascular disease mortality in later life. Individuals with history of LBW have many abnormalities...

The effects of diosmin and hesperidin on capillary blood flow of upper limbs in patients with secondary Raynaud’s syndrome

The article discusses the effects of diosmin and hesperidin on capillary blood flow in patients with secondary Raynaud's syndrome (RS). Raynaud's syndrome a difficult problem of modern angiology, since in its development there is a large range of disorders of the capillary blood flow of the limbs. Currently, the main way of therapy in patients with secondary Raynaud's syndrome is the use of either calcium channel blockers (if angiospastic stage of the disease), or prostaglandins of group E1 (with tropho-paralytic stage of secondary RS). However, pharmacological effects of calcium channel blockers (vasodilation) and prostaglandins (vasodilation, antiproliferative, anti-inflammatory etc.) do not allow impact on all violations of capillary blood flow, occurs when the Raynaud's syndrome. In this regard, the task was to study the reaction of capillary blood flow of the fingers of the hands on the concomitant use of drugs based on diosmin and hesperidin. A prerequisite for the use of a combination of diosmin and hesperidin in the treatment of RS was based on data about their impact on the state of the venous segment of the capillary bed and perivascular oedema. To conduct the study was established two groups of patients (22 in each group). The main criterion for inclusion of patients in the study was the presence of newly identified Raynaud's syndrome of angiospastic or tropho-paralytic stage of the disease. The main exclusion criteria was the presence of necrotic stage of the disease. In the first group of patients therapy was carried out using only vasodilators. In the second group (comparison group) with the addition of a combination of diosmin and hesperidin (tablets Venarus used in a dose 500 mg 2 times per day). The condition of capillary blood flow in this study was estimated by the method of videocapillaroscopy (VCS). Statistical data processing was performed using a criterion of statistical significance (P-value). The study revealed the significant impact of a combination of diosmin and hesperidin for parameters of capillary blood flow that correlated with clinical improvements - reduction of oedema of the fingers of the hands.