POSTERIOR ISCHEMIC OPTIC NEUROPATHY ASSOCIATED WITH MIGRAINE

Anterior ischemic optic neuropathy is a well-recognized clinical syndr ome that has been described in patients after an episode of migraine w ith visual aura (classic migraine) and, less commonly, after an episod e of visual aura without headache (acephalgic migraine). Little emphas is, how ever, has been placed on migraine-associated retrobulbar or po sterior ischemic optic neuropathy. We report two cases of visual loss presumed to be due to posterior ischemic optic neuropathy that occurre d in the setting of otherwise typical migraine episodes. We review the English language literature on ischemic optic neuropathy associated w ith migraine. Although most cases of ischemic optic neuropathy associa ted with migraine are of the anterior variety, posterior ischemic opti c neuropathy should be considered in the differential diagnosis of any patient with acute loss of vision and evidence for a retrobulbar opti c neuropathy, during or after an attack of migraine headache or follow ing an otherwise typical episode of visual aura without headache (acep halgic migraine).