Acephalgic retinal migraine: A 6-year follow-up case report and literature review
Abstract
Rationale: Retinal migraine is a rare cause of transient monocular visual loss that presents a significant diagnostic challenge and necessitates the careful exclusion of alternative etiologies. This case report describes the 6-year clinical course of a rare, headache-free variant of retinal migraine.
Patient concerns: A 42-year-old male experienced recurrent transient monocular visual loss episodes 2 to 3 times per year, affecting either eye, without any associated headache. Each episode involved stereotypical visual symptoms starting with photopsia, followed by an expanding altitudinal visual field defect.
Diagnoses: Extensive investigations, including neuroimaging, vascular studies, blood work, and ophthalmological examinations, returned normal results. After years of investigations and excluding other etiologies, a diagnosis of retinal migraine was established based on the International Classification of Headache Disorders 3rd edition criteria.
Interventions: The patient opted for low-dose aspirin to decrease the risk of permanent visual loss.
Outcomes: The patient continued to experience similar visual episodes without any change in frequency, severity, or characteristics.
Lessons: Retinal migraine may occur without headache, consistent with current International Classification of Headache Disorders 3rd edition criteria. Careful history-taking remains a cornerstone of accurate diagnosis, and time can serve as an invaluable diagnostic tool. Finally, a patient-centered…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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