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Sudden onset peripheral visual deficit secondary to retinal artery spasm in Raynaud’s phenomenon
  1. Yousuf Ansari1,2,
  2. Aditya Uday Kale1,
  3. Mohammad O Tallouzi2,3 and
  4. Avinash Manna1
  1. 1Department of Ophthalmology, Queen Elizabeth Hospital Birmingham,University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2Department of Ophthalmology, Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS trust,Birmingham, UK, Birmingham, UK
  3. 3Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
  1. Correspondence to Dr Yousuf Ansari; yousufansari{at}nhs.net

Abstract

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.

  • ophthalmology
  • retina
  • rheumatology

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Footnotes

  • Contributors YA identified the patient for this case report, obtained the images and consented the patient. YA and AUK contributed equally to drafting and reviewing the manuscript. YA, AUK and MT all made valuable contributions to reviewing and redrafting the manuscript. YA and AUK are joint first authors of this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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