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Retinal Capillary Ischemia Following Migraine: A Case Report
Ana Faria Pereira1, Rita Teixeira Martins1, Madalena Pinto2
1Department of Ophthalmology, Unidade Local de Saúde de São João, Porto, PRT.
Cureus
|January 10, 2025
Summary
Migraine patients may experience temporary vision loss due to retinal microvascular changes. This case highlights the importance of eye and neurological exams for migraine-related visual disturbances.
Area of Science:
- Neurology
- Ophthalmology
- Vascular Biology
Background:
- Migraine is a neurological disorder with complex genetic and environmental influences.
- Vascular factors are increasingly implicated in migraine pathophysiology.
- Visual aura is a common neurological symptom preceding migraine headaches.
Observation:
- A 41-year-old male with a history of migraine with visual aura presented with acute left-eye visual loss.
- Ophthalmologic examination revealed a central scotoma.
- Spectral-domain optical coherence tomography (SD-OCT) showed focal alterations in the outer plexiform layer.
Findings:
- The central scotoma persisted for two weeks before spontaneous resolution.
- Fundoscopic exam and head CT were normal.
- Follow-up imaging and visual field tests confirmed complete resolution of abnormalities.
Implications:
- This case suggests potential retinal microvascular alterations in migraine patients.
- These alterations may predispose individuals to retinal ischemia.
- Thorough ophthalmologic and neurological assessments are crucial for migraine patients with visual symptoms, considering conditions like acute macular neuroretinopathy (AMN) and paracentral acute middle maculopathy (PAMM).
