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August 1988

Inner Retinal Layer Loss in Complicated Migraine

Author Affiliations

Los Angeles
Pasadena, Calif

Arch Ophthalmol. 1988;106(8):1035-1037. doi:10.1001/archopht.1988.01060140187016

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To the Editor.  —The multitude of signs and symptoms in migrainous vasculopathy ranges from the common visual prodromes and transient hemicephalic syndromes of cephalgia with sensory and motor losses to the permanent sequelae of complicated migraine.1 The latter may be due to retinal or optic nerve ischemia; more commonly, there is compromise of the posterior circulation of the brain, producing cortical ischemia and hemianopia. Permanent monocular impairment of visual acuity and visual field loss, often accompanied by an afferent pupillary defect, have been reported in cases of anterior ischemic optic neuropathy, central retinal or ophthalmic artery constriction, and hemicranial vasoconstriction.2

Report of a Case.  —A 38-year-old man presented with an initial "small, transparent swirling design in the lower left visual field of the left eye" that had progressed to cover the whole field over the previous month. He had suffered from classic, mostly left-sided migraine since age 10

Connor RCR:  Complicated migraine: A study of permanent neurological and visual defects caused by migraine . Lancet 1962;2:1072-1075.Article
O'Hara M, Connor PS:  Migrainous optic neuropathy . J Clin Neuro Ophthalmol 1984;4:85-90.
Walsh FB, Hoyt WF:  Vascular lesions and circulatory disorders of the nervous system: Ocular signs , in Walsh FB (ed): Clinical Neuroophthalmology , ed 3. Baltimore, Williams & Wilkins, 1969, vol 2, chap 11.