González-Martín-Moro Julio, Porta Etessam Jesús, Pilo de la Fuente Belén, Fuentes Vega Irene, Contreras Inés
Ophthalmology Department, University Hospital of Henares, Madrid, Spain.
Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain.
Eur J Ophthalmol. 2023 May;33(3):NP52-NP55. doi: 10.1177/1120672120984408. Epub 2020 Dec 24.
Migraine is one of the most common causes of transient visual loss. Optical coherence tomography angiography (OCTA) provides fast and non-invasive imaging of the retinal vessels. We report one case of monocular retinal oligemia demonstrated using OCTA during a migraine attack with aura.
A 27-year-old man with a previous history of migraine with visual aura was seen in the emergency room due to acute left hemicranial pain with positive visual symptoms in his right eye. The patient reported a blue stain in his right eye. Optical coherence tomography angiography (OCT-A) showed an extensive area of hypoperfusion in the macular region of his right eye. Forty-eight hours later visual symptoms had improved and the OCT-A showed a significant reduction in the area of hypoperfusion. Seven days later the patient was asymptomatic and retinal perfusion had returned to normal values.
Monocular involvement suggests that these retinal vascular changes are independent from cerebral vascular changes, supporting the hypothesis of selective retinal ganglion cell layer spreading depression as the possible cause of some cases of retinal migraine.
偏头痛是短暂性视力丧失最常见的原因之一。光学相干断层扫描血管造影（OCTA）可对视网膜血管进行快速、无创成像。我们报告1例在偏头痛发作伴先兆期间使用OCTA显示单眼视网膜缺血的病例。
一名27岁男性，既往有偏头痛伴视觉先兆病史，因急性左侧头痛伴右眼出现阳性视觉症状而在急诊室就诊。患者报告右眼有蓝色斑块。光学相干断层扫描血管造影（OCT - A）显示其右眼黄斑区有大面积灌注不足区域。48小时后视觉症状有所改善，OCT - A显示灌注不足区域显著缩小。7天后患者无症状，视网膜灌注恢复至正常水平。
单眼受累表明这些视网膜血管变化与脑血管变化无关，支持选择性视网膜神经节细胞层扩散性抑制假说，该假说可能是某些视网膜偏头痛病例的病因。
