In clinical practice the Flammer syndrome can be diagnosed with some certainty based on the patient’s history (such as cold hands or feet) and clinical examinations (such as 24-h blood pressure monitoring).
If necessary, the diagnosis can then be substantiated by more specific examinations such as
- nailfold capillaroscopy with a cold provocation test
- dynamic retinal vessel analysis with flicker-light stimulation
- quantification of gene expression in lymphocyte
- measurement of retinal venous pressure
- quantification of Endothelin plasma level
Examples of more specific examinations are capillary microscopy (top) and Dynamic Retinal Vessel Analysis, DVA (bottom).