Abstract
Retinal migraine was first formally described in 1882. Various terms such as “ocular migraine” and “ophthalmic migraine” have since been used interchangeably in the literature. The lack of a consistent consensus-based definition has led to controversy and potential confusion for clinicians and patients. Retinal migraine as defined by the International Classification of Headache Disorders (ICHD) has been found to be rare. The latest ICHD defined retinal migraine as ‘repeated attacks of monocular visual disturbance, including scintillation, scotoma or blindness, associated with migraine headache’, which are fully reversible. Retinal migraine should be considered a diagnosis of exclusion, which requires other causes of transient monocular visual loss to be excluded. The aim of this narrative review is to summarize the literature on retinal migraine, including: epidemiology and risk factors; proposed aetiology; clinical presentation; and management strategies. It is potentially a misnomer as its proposed aetiology is different from our current understanding of the mechanism of migraine
Highlights
Introduction and Historical EvolutionThere has been extensive documentation of migraine as a disorder, dating back to over 4000 years ago from ancient Mesopotamia [1]
In 1882, Galezowski first used the term ophthalmic megrim to describe a case series of four patients with permanent monocular visual loss and migraine headaches. He hypothesized that ophthalmic megrim is a condition that may ‘occasionally lead to organic changes in the retina or retinal vessels’, with findings such as retinal thrombosis and optic disc atrophy [2]
We have summarized the literature on retinal migraine as defined by the latest International Classification of Headache Disorders (ICHD), to include epidemiology and risk factors, proposed aetiology, clinical presentation, and management strategies
Summary
There has been extensive documentation of migraine as a disorder, dating back to over 4000 years ago from ancient Mesopotamia [1]. The term retinal migraine was first introduced by Caroll in 1970 when he suggested that controversial, it could ‘possibly be applied to uncommon cases’ of migraine [3] He presented a case series of 15 patients with monocular visual loss without associated features of headache, mostly transient with a duration of less than 10 min and rarely lasting more than an hour. In the latest 2018 ICHD-3, retinal migraine is defined as ‘repeated attacks of monocular visual disturbance, including scintillation, scotoma, or blindness, associated with migraine headache’ [9]. ICHD classification of retinal migraine [9]
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