Dynamic focal retinal arteriolar vasospasm in migraine

Area of Science:

• Ophthalmology
• Vascular Neurology

Background:

• Retinal artery occlusions can cause sudden vision loss.
• Retinal vascular spasm is a less common cause, often transient.

Observation:

• A 48-year-old man experienced simultaneous vision loss in one eye and visual disturbances in the other.
• Examination revealed left superior hemiretinal artery occlusion and dynamic spasm in the right superior temporal branch retinal artery.

Findings:

• Extensive hematological, carotid, and cardiac investigations were unremarkable.
• The patient was treated with acetazolamide, timolol, amyl-nitrate, felodipine, and aspirin.
• The focal arteriolar spasm resolved within two months.

Implications:

• This is the first reported case of photographically documented dynamic focal retinal vascular spasm.
• Highlights the importance of considering dynamic arteriolar spasm in the differential diagnosis of acute visual disturbances.
• Suggests potential therapeutic targets for managing such vascular events.