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LETTER TO THE EDITOR
Year : 2015  |  Volume : 63  |  Issue : 10  |  Page : 809-810

Raynaud's phenomena and subclavian steal syndrome: Differential diagnosis for retinal artery occlusion


Department of Neuro-ophthalmology, Clinic and Glaucoma Service, AG Eye Hospital, Tiruchirappalli, Tamil Nadu, India

Date of Web Publication10-Dec-2015

Correspondence Address:
Dr. Natarajapillai Venugopal
No. 19, Mathuram Apartments (Behind YMCA), Officer's Colony, Puthur, Tiruchirappalli - 620 017, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.171538

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How to cite this article:
Venugopal N. Raynaud's phenomena and subclavian steal syndrome: Differential diagnosis for retinal artery occlusion. Indian J Ophthalmol 2015;63:809-10

How to cite this URL:
Venugopal N. Raynaud's phenomena and subclavian steal syndrome: Differential diagnosis for retinal artery occlusion. Indian J Ophthalmol [serial online] 2015 [cited 2019 Dec 14];63:809-10. Available from: http://www.ijo.in/text.asp?2015/63/10/809/171538

Dear Sir,

We read with interest the article titled, "Cilioretinal artery occlusion following intranasal cocaine insufflation" by Kannan et al. [1] We appreciate the authors' research work. We would like to highlight few points regarding Raynaud's phenomena which are a differential diagnosis for vaso-occlusive disorder. Raynaud's phenomena [2] are characterized by exaggerated vasoconstrictive color changes (pallor and cyanosis) in the fingers, usually due to exposure to cold. Primary Raynaud's phenomena (PRP) are not associated with underlying systemic disease. Secondary Raynaud's is associated with systemic lupus erythematosus, scleroderma, and peripheral vascular disease. [2] Stress is a risk factor for Raynaud's phenomena. [3] PRP may be a manifestation of diffuse vasospastic disorder affecting cerebral, coronary, mesenteric vessels. PRP patients have higher incidence of chest pain, migraine, and stroke. Evidence suggest that abnormalities in smooth muscle and endothelium of blood vessels, central sympathetic control of vascular tone, and circulating mediators may all be involved in its pathogenesis. Calcium channel blockers, topical nitroglycerine (fingers), and sildenafil may play a part in management of Raynaud's phenomena. [3] Ophthalmic artery vasospasm due to subclavian steal syndrome may clinically present as incomplete central retinal artery and short posterior ciliary artery occlusion. [4]

To conclude, Raynaud's phenomena and subclavian steal syndrome should be considered in differential diagnosis of ocular arterial occlusion disease.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kannan B, Balaji V, Kummararaj S, Govindarajan K. Cilioretinal artery occlusion following intranasal cocaine insufflations. Indian J Ophthalmol 2011;59:388-9.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Rodgers M. Images in clinical medicine. Primary Raynaud′s phenomenon. N Engl J Med 2013;368:1344.  Back to cited text no. 2
    
3.
Roberts H, Tomlinson S. Cerebral vasospasm and primary Raynaud′s phenomenon. Br J Anaesth 2008;101:743-4.  Back to cited text no. 3
[PUBMED]    
4.
Makino S, Takezawa M, Sato Y. A case of incomplete central retinal artery occlusion associated with short posterior ciliary artery occlusion. Case Rep Ophthalmol Med 2013;2013:105653.  Back to cited text no. 4
    




 

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