• Comprehensive Ophthalmology, Neuro-Ophthalmology/Orbit

    Researchers evaluated pharmacologic treatment options for visual snow and reported the prevalence of comorbid diseases.

    Study design

    The authors examined the medical charts of 58 patients with a diagnosis of visual snow between 2007 and 2018. They collected data on prescribed medications and comorbid conditions such as migraine, tinnitus and psychiatric conditions.

    Outcomes

    Comorbid migraine was present in 51.7% of patients, lifetime depression in 41.4% and lifetime anxiety in 44.8%. Lamotrigine—the most frequently prescribed drug—led to partial remission of symptoms in 5 of 26 patients (19.2%). No patients reported complete remission. Half of lamotrigine-treated patients experienced adverse events.

    By contrast, none of the other prescribed drugs (valproate, topiramate, acetazolamide and flunarizine) led to improvement with the exception of topiramate in 1 patient who discontinued, however, because of adverse events.​

    Limitations

    This study was limited by its retrospective nature. In addition, depression/anxiety questionnaire data were only available for 62.1% of patients. 

    Clinical significance

    The findings here suggest that lamotrigine can lead to partial remission of symptoms in a small minority of patients. Migraine, depression, anxiety, and tinnitus were common comorbid diseases in patients with visual snow.​