Do vasospasms provoke ocular diseases?
Vasospasms in the eye are often combined with digital vasospasms, as can be diagnosed with a nailfold capillaroscopic local cooling test. In 16 patients with a history of cold hands and feet the presence of peripheral vasospasms without any underlying disease was demonstrated by means of nailfold video-capillaroscopy. These patients showed the phenomenologic diagnosis of low-tension glaucoma with visual field defects characteristic of glaucoma even though intraocular pressure above 21 mmHg was excluded. The visual field defects were not homonymous, indicating a prechiasmal location of the vascular disturbance. Ocular vasospasms cause visual field damage that can be aggravated or provoked by cooling one hand in cold water and that often improves after treatment with the calcium channel blocker nifedipine. The results suggest that vasospasms not only are present in Raynaud's disease, migraine, and Prinzmetal's variant angina but also may be an important factor in the genesis of low-tension glaucoma. This is a new finding and may be related to a general vasospastic syndrome.