Retinal connections to migraine

This narrative review aims to examine potential associations between migraine and retinal disorders, with particular attention to retinal migraine, age-related macular degeneration (AMD), retinal vascular occlusions, and photophobia.

The role of retinal pathways in migraine pathophysiology remains poorly understood. As a component of the central nervous system, the retina provides a unique and accessible window into neuronal structure and function. Emerging observations suggest that structural and functional retinal changes may occur in individuals with migraine; however, their relevance and consistency across studies remain uncertain.

Visual phenomena are characteristic of migraine aura, yet the extent to which migraine affects retinal structure and function is still unclear. Retinal migraine, while suggestive of a direct retinal involvement, is rare and insufficiently characterized to support mechanistic conclusions. Epidemiological data indicate that individuals with migraine may have an increased risk of neovascular AMD, raising the possibility of shared pathogenic pathways. In addition, photophobia, retinal artery occlusion, and alterations in retinal nerve fiber layer thickness have been reported more frequently in migraine patients than in controls, although causality has not been established. Mechanisms implicated in AMD, including microvascular dysfunction, impaired DNA damage response, disrupted autophagy, and mitochondrial dysregulation, have also been proposed in migraine, but evidence remains limited.

Migraine has been linked to several retinal conditions, with AMD showing the most consistent association. While overlapping biological processes are suggested, further studies are needed to clarify their significance and determine whether retinal alterations contribute to migraine pathophysiology or represent secondary phenomena.