Ophthalmic manifestations of chronic migraine

Abstract

Department of Ophthalmology, Nicolae Testemitsanu State University of Medicine and Pharmacy, Institute for Neurology and Neurosurgery, Chisinau, the Republic of MoldovaBackground: Migraine is a common disorder and its pathogenesis remains still unclear. Several hypotheses about the mechanisms involved in the pathogenesis of migraine have been proposed, but the issue is still far from being fully clarified. Neurovascular system remains one of the most important mechanisms involved in the pathogenesis of migraine and it could be possible that hypo-perfusion might involve other areas besides brain, including the retina. This is, for example, of particular interest in a form of migraine, the retinal migraine, which has been associated with hypo-perfusion and vasoconstriction of the retinal vasculature. Although vasoconstriction of cerebral and retinal vessels is a transient phenomenon, the chronic nature of the migraine might cause permanent structural abnormalities of the brain and also of the retina. On this basis, a few studies have evaluated whether retina is involved in migraine patients. Migraine is divided into two major subtypes: migraine without aura and migraine with aura. Migraine without aura is characterized by at least five attacks of recurrent headache lasting somewhere from 4 to 72 h. The other major subtype is migraine with aura, characterized by recurrent attacks of reversible focal neurological symptoms that usually develop gradually over 5-20 min and last for less than 60 min. If aura-like phenomenon is persistent, and ophtalmic deaseases are excluded, an examination through neurovisualization is recommended (MRI, CT). Conclusions: Although the vasospasm of cerebral and retro-bulbar blood vesselsis a transient phenomenon, the chronic nature of the disease might be a risk factor for structural abnormalities of the brain and perhaps the retin