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Review
. 2021 May 11;21(7):35.
doi: 10.1007/s11910-021-01122-1.

Retinal Migraine: Evaluation and Management

Monica E Maher  1 , William Kingston  2   3   4
Affiliations
Review

Retinal Migraine: Evaluation and Management

Monica E Maher et al. Curr Neurol Neurosci Rep. .

Abstract

Purpose of review: This review aims to summarize the last 15 years of literature and case reports detailing retinal migraine-an uncommon and somewhat poorly understood migraine variant.

Recent findings: In the last 15 years, only 12 cases of retinal migraine have been outlined. Similar to other migraine statistics, retinal migraine appears to affect women more so than men and presents with unilateral headache which tends to be ipsilateral to the side of vision loss. The pathophysiology may relate to vasoconstriction of retinal vessels, as evidenced by ictal fundus photography in the past few years. Retinal migraine is a rare entity, with a paucity of described cases in the literature. Retinal migraine is a diagnosis of exclusion, as monocular vision loss might be ascribed to several concerning disorders requiring urgent diagnosis and treatment, and any patient presenting as such should be thoroughly investigated. Patients suffering from retinal migraine appear to respond to typical migraine abortive therapies including NSAIDs and migraine prophylactic medications.

Keywords: Migraine aura; Monocular vision loss; Ophthalmologic migraine; Retinal migraine; Visual aura.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance
    1. Galezowski X. Ophthalmic megrim: an affection of the vasomotor nerves of the retina and retinal centre which may end in a thrombosis. Lancet. 1882;1:176–9. - DOI
    1. IHS Classification ICHD-3 [Internet]. ICHD-3. International Headache Society; 2021. Available from: https://ichd-3.org/1-migraine/1-2-migraine-with-aura/1-2-4-retinal-migra...
    1. Hill DL, Daroff RB, Ducros A, Newman NJ, Biousse V. Most cases labeled as “retinal migraine” are not migraine. J Neuro-Ophthalmol. 2007;27:3–8. - DOI
    1. Evans RW, Daroff RB. Monocular visual aura with headache: retinal migraine? Headache. 2000;40:603–4. - DOI
    1. • El Youssef N, Maalouf N, Mourad A, Saade J, Khoury M. Teaching NeuroImages: retinal migraine in action. Neurology. 2018;90:e992 This report provided evidence for potential underlying pathophysiology for retinal migraine by performing ictal fundus photography; this indicated reversible central and branch retinal artery vasoconstriction during and after an episode of retinal migraine. It is the first publication on the topic to do so. - DOI

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