Sudden onset peripheral visual deficit secondary to retinal artery spasm in Raynaud’s phenomenon

A 32-year-old doctor, who has a medical history of primary Raynaud’s disease and previous scotomas, presented to eye clinic with sudden onset blurring of vision (infero-nasally) with no other associated symptoms. The patient had good visual acuity bilaterally (6/6) and no anterior chamber activity o...

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Bibliographic Details
Published in:BMJ case reports 2021-02, Vol.14 (2), p.e239954
Main Authors: Ansari, Yousuf, Kale, Aditya Uday, Tallouzi, Mohammad O, Manna, Avinash
Format: Article
Language:English
Subjects:
Adult
Blood tests
Case Report
Case reports
Cold
Diagnosis, Differential
Disease
Edema
Female
Humans
Medical imaging
Nervous system
Raynaud Disease - complications
Retinal Artery
Retinal Diseases - etiology
Scleroderma
Spasm - etiology
Thromboembolism
Ultrasonic imaging
Vascular Diseases - etiology
Veins & arteries
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Summary:A 32-year-old doctor, who has a medical history of primary Raynaud’s disease and previous scotomas, presented to eye clinic with sudden onset blurring of vision (infero-nasally) with no other associated symptoms. The patient had good visual acuity bilaterally (6/6) and no anterior chamber activity or conjunctival hyperaemia. Findings consistent with a nerve fibre layer infarct were noted in the right eye, with unremarkable examination of the left eye. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images were obtained, which showed an area of capillary shut down in keeping with a nerve fibre layer lesion. Previous literature pertaining to similar symptoms is sparse with symptoms such as migraines, epilepsy and visual loss being stated. This case provides further evidence of Raynaud’s associated retinal artery spasm, with complete resolution at 4 weeks. We also demonstrate the accessibility of OCT and more importantly OCTA for investigation of sudden onset visual deficit.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-239954