Neuro-ophthalmology and migraine: visual aura and its neural basis
Dublin Core
Title
Neuro-ophthalmology and migraine: visual aura and its neural basis
Subject
Migraine, Visual aura, Cortical spreading depression, Scintillating scotoma, Fortification spectra,
Neuroimaging, Neuro-ophthalmology, Migraine management
Neuroimaging, Neuro-ophthalmology, Migraine management
Description
Abstract
Background Migraine, a chronic neurological condition often accompanied by visual aura, which affects 15–33%
of migraineurs, often presents as transient visual disturbances such as scintillating scotoma and teichopsia. These
symptoms arise primarily from cortical spreading depression (CSD) within the occipital cortex and significantly
impacts the quality of life, with chronic and episodic migraineurs consistently scoring lower scores in vision-specific
quality of life questionnaires. Therefore, this narrative review explores the pathophysiology pertaining to visual aura in
migraines, focusing on the role of CSD while evaluating current diagnostic and therapeutic approaches employed.
Methods A narrative literature review was conducted using PubMed and ScienceDirect, focusing on studies
published between 2000 and 2025. Search terms related to “migraine”, “visual aura”, and “cortical spreading depression”
were used to identify relevant original research, reviews, and clinical studies addressing the pathophysiology,
diagnosis, and treatment of migraine-related visual aura.
Results Findings indicate that CSD drove transient visual symptoms by triggering waves of neuronal depolarization
and hypoperfusion in the visual cortex. Contemporaneous treatment modalities target the headache phase of
migraine, with limited alternatives for aura-specific intervention.
Conclusion Advancement in neuroimaging and genetic research offer promising avenues for early diagnosis
alongside focused therapeutics for migraine with aura. However, current treatment strategies remain largely focused
on the headache phase, with limited efficacy for aura-specific symptoms. Future therapeutic approaches targeting
cortical spreading depression may offer more precise interventions for managing visual aura in migraine.
Keywords Migraine, Visual aura, Cortical spreading depression, Scintillating scotoma, Fortification spectra,
Neuroimaging, Neuro-ophthalmology, Migraine management
Background Migraine, a chronic neurological condition often accompanied by visual aura, which affects 15–33%
of migraineurs, often presents as transient visual disturbances such as scintillating scotoma and teichopsia. These
symptoms arise primarily from cortical spreading depression (CSD) within the occipital cortex and significantly
impacts the quality of life, with chronic and episodic migraineurs consistently scoring lower scores in vision-specific
quality of life questionnaires. Therefore, this narrative review explores the pathophysiology pertaining to visual aura in
migraines, focusing on the role of CSD while evaluating current diagnostic and therapeutic approaches employed.
Methods A narrative literature review was conducted using PubMed and ScienceDirect, focusing on studies
published between 2000 and 2025. Search terms related to “migraine”, “visual aura”, and “cortical spreading depression”
were used to identify relevant original research, reviews, and clinical studies addressing the pathophysiology,
diagnosis, and treatment of migraine-related visual aura.
Results Findings indicate that CSD drove transient visual symptoms by triggering waves of neuronal depolarization
and hypoperfusion in the visual cortex. Contemporaneous treatment modalities target the headache phase of
migraine, with limited alternatives for aura-specific intervention.
Conclusion Advancement in neuroimaging and genetic research offer promising avenues for early diagnosis
alongside focused therapeutics for migraine with aura. However, current treatment strategies remain largely focused
on the headache phase, with limited efficacy for aura-specific symptoms. Future therapeutic approaches targeting
cortical spreading depression may offer more precise interventions for managing visual aura in migraine.
Keywords Migraine, Visual aura, Cortical spreading depression, Scintillating scotoma, Fortification spectra,
Neuroimaging, Neuro-ophthalmology, Migraine management
Creator
Hajar Nasir Tukur1,2, Olivier Uwishema1* , Dalal Sheikhah1,2 and Hatice Akbay1,3
Date
2025
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Hajar Nasir Tukur1,2, Olivier Uwishema1* , Dalal Sheikhah1,2 and Hatice Akbay1,3, “Neuro-ophthalmology and migraine: visual aura and its neural basis,” Repository Horizon University Indonesia, accessed April 15, 2026, https://repository.horizon.ac.id/items/show/13224.