Retinal Arterial Occlusion in Migraine

Graveson, G. S.

doi:10.1136/bmj.2.4632.838

Cited by 40 publications

(12 citation statements)

References 6 publications

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“…This feature supports its suitability for use in clinical practice and is the reason for us choosing to use it in our study for the grading of migraine severity. MIDAS scores are graded as having minimal or infrequent disability (0-5), mild or frequent disability (6-10), moderate disability (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and severe disability (21+). In our study, nearly all migraine cases were severely disabled according to the MIDAS score.…”

Section: Discussionmentioning

confidence: 99%

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Short-wavelength automated perimetry in patients with migraine

Yenice

Temel

Incili

et al. 2005

Graefe's Arch Clin Exp Ophthalmo

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Section: Discussionmentioning

confidence: 99%

“…Migraine is a disease associated with decreased cerebral blood flow and attacks of migraine have been reported to be related to ischemic infarctions of the brain [2,5], retina [2,12,24], and optic nerve [31]. There are reports in the literature demonstrating an increased prevalence of migraine in patients with glaucoma [3,25,29,31].…”

Section: Introductionmentioning

confidence: 98%

Short-wavelength automated perimetry in patients with migraine

Yenice

Temel

Incili

et al. 2005

Graefe's Arch Clin Exp Ophthalmo

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“…Two of these had developed central retinal artery thrombosis, one had a superior branch occlusion, while the fourth showed peripheral retinal arterial thrombosis with fundal haemorrhages. Four further cases were reported by Graveson (1949). Where the circulation to the optic nerve is affected, the related condition of ischaemic papillopathy may occur, as described by McDonald & Sanders (1971).…”

Section: Discussionmentioning

confidence: 96%

Retinal artery occlusion in migraine

Gray

Carroll

1985

Postgraduate Medical Journal

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Summary:Retinal artery occlusion is a rare complication of migraine. The following case report highlights the importance of early diagnosis in this condition. The long term management of patients with this and other forms of complicated migraine is discussed. Case reportThe patient, a 33 year old hospital ward clerk, had suffered from attacks of classical migraine since the age of 6. These occurred on average twice each month, invariably starting with teichopsia, followed by a severe unilateral headache associated with nausea or vomiting. Her attacks normally lasted from 12 to 24 h and could sometimes be aborted by early ingestion of analgesics.The attack in question commenced while she was eating breakfast, the first symptom being teichopsia as usual. Ten minutes later, however, she was alarmed to find that the left side of her face and left arm had become numb. She took two 'pink Migraleve' tablets but after a further 5 min a 'curtain' seemed to come down over her left eye, with complete loss of vision on this side. This was followed by a severe headache, commencing behind the left eye but later encompassing the whole forehead. It persisted for the rest of the day and kept her awake for most of that night. The following morning there was still no vision in the left eye. She was visited by her general practitioner, who referred her to her local hospital. A series of delays, however, meant that she was not seen until more than 48 h after the onset of blindness. A diagnosis of retinal artery thrombosis was made at this stage, the classical appearance being seen on ophthalmoscopy.Physical examination was otherwise normal. Her blood pressure was 130/70mmHg. An attempt was made to improve retinal blood flow using oral nifedipine and she was commenced on oral steroids. These measures were, however, to no avail. She was referred to our department for a neurological opinion. Investigations showed that her full blood count, erythrocyte sedimentation rate, urea and electrolytes, glucose, cholesterol and triglycerides, liver function tests, total protein and protein electrophoresis were all within normal limits. Chest and skull radiographs, an electrocardiogram, an ultrasonogram of the carotid arteries and a computed tomographic brain scan were all normal. Visual evoked responses were normal in the right eye but were completely absent in the left eye. She had two further attacks of migraine while in the ward and was commenced on prophylactic treatment with pizotifen 0.5mg t.d.s. Three months later, she showed no sign of recovery of the vision in her left eye, although the frequency of her migraine attacks had decreased to one every 3 weeks. She has recently started taking additional prophylaxis in the form of aspirin 300 mg, once daily.

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“…In a patient studied by Wolff, 1 photographic evidence was obtained of retinal artery constriction during attacks of scotoma, which were relieved by prompt administration of amyl nitrate. Graveson 16 described four patients with scotoma during attacks associated with retinal vascular changes and retinal edema. In one patient, 17 the administration of ergotamine tartrate prolonged the visual aura, thereby confirming its ischemic basis.…”

Section: Discussionmentioning

confidence: 99%