Faria Pereira Ana, Teixeira Martins Rita, Pinto Madalena, Faria Olinda, Penas Susana
Department of Ophthalmology, Unidade Local de Saúde de São João, Porto, PRT.
Department of Neurology, Unidade Local de Saúde de São João, Porto, PRT.
Cureus. 2024 Dec 9;16(12):e75428. doi: 10.7759/cureus.75428. eCollection 2024 Dec.
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.
偏头痛是一种常伴有视觉障碍、恶心和畏光等症状的神经系统疾病，涉及遗传和环境因素之间的复杂相互作用，同时血管因素也受到牵连，受到遗传易感性和环境触发因素的影响。本病例报告讨论了一名41岁有偏头痛伴视觉先兆病史的男性，出现突发左眼视力丧失。全面的眼科检查发现中心暗点，而包括光谱域光学相干断层扫描（SD-OCT）在内的多模态成像显示外丛状层有局灶性改变。尽管眼底检查和头部CT正常，但暗点持续了两周才自行消退。随访成像和视野检查显示异常完全消失。该病例强调了偏头痛中视网膜微血管改变的可能性，这可能使患者易患视网膜缺血，因此在此类病例中需要进行全面的眼科和神经学评估。急性黄斑神经视网膜病变（AMN）和中心旁急性黄斑病变（PAMM）等疾病可能与偏头痛有共同的病理生理学。
