Retinal Capillary Ischemia Following Migraine: A Case Report

Migraine, a neurological disorder often accompanied by symptoms such as visual disturbances, nausea, and photophobia, involves complex interactions between genetic and environmental factors, while vascular factors are also implicated, influenced by both genetic predisposition and environmental triggers. This case report discusses a 41-year-old male with a history of migraine with visual aura, presenting with sudden left-eye visual loss. Comprehensive ophthalmologic examination revealed a central scotoma, while multimodal imaging, including spectral-domain optical coherence tomography (SD-OCT), showed focal alterations in the outer plexiform layer. Despite a normal fundoscopic exam and head CT, the scotoma persisted for two weeks before resolving spontaneously. Follow-up imaging and visual field tests showed complete resolution of abnormalities. This case underlines the potential for retinal microvascular alterations in migraine, which may predispose patients to retinal ischemia, necessitating thorough eye and neurological assessments in such cases. Conditions like acute macular neuroretinopathy (AMN) and paracentral acute middle maculopathy (PAMM) may share a common pathophysiology with migraine.