Persistent monocular visual loss in migraine patients

Area of Science:

• Ophthalmology
• Neurology
• Neuroscience

Background:

• The link between migraine and visual disturbances is complex.
• Persistent monocular visual alterations are reported in migraineurs.
• Migraine classification includes visual aura and persistent visual aura without infarction.

Purpose of the Study:

• To investigate migraine as a potential risk factor for persistent monocular visual loss.
• To present new cases and discuss the differential diagnosis of monocular visual loss in migraineurs.
• To explore the relationship between migraine and unexplained persistent monocular visual defects.

Main Methods:

• Case series of five young patients with migraine and persistent monocular visual defects.
• Extensive clinical investigations including automated perimetry and fundoscopy.
• Fluorescein angiography in a patient with retinal vasculitis.

Main Results:

• Four of five patients experienced visual defects during a migraine with aura episode.
• Automated perimetry confirmed scotoma in three patients.
• Retinal vasculitis and transient cotton wool spots were observed in some cases; etiology was often inconclusive.

Conclusions:

• Monocular visual loss can stem from various ocular pathologies.
• Urgent conditions must be ruled out in cases of monocular visual loss.
• Migraine should be considered a potential contributing factor for unexplained persistent monocular scotoma.