Gasser P, Flammer J, Guthauser U, Mahler F
Department of Internal Medicine, St. Claraspital, Basel, Switzerland.
Angiology. 1990 Mar;41(3):213-20. doi: 10.1177/000331979004100306.
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.
眼部血管痉挛常与手指血管痉挛同时出现,可通过甲襞毛细血管镜局部冷却试验进行诊断。通过甲襞视频毛细血管镜检查,在16例有手足冰冷病史的患者中证实存在无任何潜在疾病的外周血管痉挛。这些患者表现出低眼压性青光眼的现象学诊断,伴有青光眼特征性的视野缺损,尽管排除了眼压高于21 mmHg的情况。视野缺损并非同向性,表明血管紊乱位于视交叉前。眼部血管痉挛会导致视野损害,用冷水冷却一只手会使其加重或诱发,而用钙通道阻滞剂硝苯地平治疗后通常会改善。结果表明,血管痉挛不仅存在于雷诺病、偏头痛和变异型心绞痛中,还可能是低眼压性青光眼发病的一个重要因素。这是一项新发现,可能与一种全身性血管痉挛综合征有关。