A Case of Prolonged Bilateral Inferior Altitudinal Visual Field Defect in a Young Migraineur

ABSTRACT

PURPOSE: To report a case of prolonged bilateral inferior altitudinal visual field defect in a young migraine patient. CASE SUMMARY: A 13-year-old female patient presented with bilateral disturbance of visual acuity and visual field, which had begun one month before. She complained of headache, with recently increasing frequency, that occurred 3 or 4 days a week for about 2~3 hours duration, sometimes accompanied by nausea and located in the frontotemporal and retrobulbar area. Brain magnetic resonance imaging showed no abnormal finding in the brain and orbit. Her visual acuity was hand motion in both eyes and Humphrey visual field test showed bilateral inferior altitudinal visual field defect. Pupillary resonse was normal and extraocular muscle movement, anterior segment and fundus were also normal in ophthalmologic examination. Her best corrected visual acuity was 1.0 in both eyes by fogging method, but bilateral inferior altitudinal visual field defect persisted for 6 months follow-up. CONCLUSIONS: Bilateral inferior altitudinal visual field defect can be developed in a migraine patient without other causes. Careful examinations to rule out other causes such as ischemic optic neuropathy or brain infarct should be performed in a migraine patient who complains of visual disturbance.