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November 20, 1991

Subcutaneous Sumatriptan in Acute Migraine-Reply

Author Affiliations

The Shealy Institute Springfield, Mo

The Shealy Institute Springfield, Mo

JAMA. 1991;266(19):2703-2704. doi:10.1001/jama.1991.03470190051022

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In Reply.  —Dr Korenfeld raises the question of whether visual disturbances associated with subcutaneous sumatriptan could have resulted from relative ischemia secondary to posterior ciliary artery or central renal artery vasoconstriction.When we reviewed the patients who were experiencing visual difficulties, we noted that seven of the 734 sumatriptan-treated patients had true visual disturbances. These complaints generally began minutes after the subcutaneous injection of sumatriptan and resolved within several minutes to 1 hour. In only a single patient who received a second dose of sumatriptan was the visual disturbance duplicated by the second injection. No long-term visual complaints were noted except in a single patient who had blurred vision in one eye, which began several hours after the sumatriptan injection, and a subsequent ophthalmologic evaluation concluded that this problem was secondary to her severe myopia and not to sumatriptan.Whether the posterior ciliary artery or the central retinal artery has