Macular capillary hemodynamic changes associated with Raynaud's phenomenon

Abstract

Background: Raynaud's phenomenon is an episodic, reversible spasm of the digital arterioles. Previous studies have suggested that Raynaud's phenomenon may be associated with alterations in the ocular circulation. The authors used the blue field entoptic simulation technique to study macular retinal capillary hemodynamics in patients with Raynaud's phenomenon.

Methods: Forty-two volunteers participated in the study: 18 with a connective tissue disease and secondary Raynaud's phenomenon, 8 with a connective tissue disease and no Raynaud's phenomenon, and 16 healthy volunteers. The mean of three blue field entoptic density and velocity measurements was determined before as well as during and 10 minutes after the immersion of one hand in ice water.

Results: Patients with severe Raynaud's phenomenon demonstrated a statistically significant 30% decrease in retinal capillary flow during immersion of a hand in ice water (P less than 0.05), which remained 17% reduced (P less than 0.05) for at least 10 minutes after removal. The decrease in capillary flow was not observed in control individuals or in individuals with connective tissue disease who demonstrated minimal or no Raynaud's phenomenon.

Conclusion: The prolonged reduction in retinal capillary flow observed in subjects with Raynaud's phenomenon is probably caused by retinal arteriolar vasoconstriction and is similar to concurrent arteriolar vasoconstriction reported in other systemic vascular beds. In the retina, the recurrent ischemic episodes may result in dysfunction or injury.