New Study: “Visual snow syndrome: recent advances in understanding the pathophysiology and potential treatment approaches”

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Study Title

“Visual snow syndrome: recent advances in understanding the pathophysiology and potential treatment approaches”


Current Opinion in Neurology


Aeschlimann, Sarah A.; Klein, Antonia; Schankin, Christoph J.

Key Points

  • Visual snow syndrome involves cortical hyperresponsivity and is assumed to be a network disorder.
  • Aberrant thalamocortical circuits and altered neurotransmitter systems might play a key role in the underlying pathophysiology.
  • Promising treatments include mindfulness-based cognitive therapy (MBCT), tinted glasses, neuro-optometric visual rehabilitation therapy and research on adaption to visual noise.
  • Pharmacological attempts have been frustrating so far, but our improved understanding of the pathophysiology combined with neuroimaging might, in the future, point to more customized treatment approaches.
  • Further research is needed, including larger trials and objective measurement methods.


Purpose of review 

Visual snow syndrome (VSS) is a disorder characterized by persistent visual disturbances, including the visual snow phenomenon, palinopsia, heightened perception of entoptic phenomena, impaired night vision, and photophobia. The purpose of this review is to provide an update on recent findings over the past 18 months in VSS research and to summarize the current state of treatment approaches.

Recent findings 

Electrophysiological studies have revealed cortical hyperresponsivity in visual brain areas, imaging studies demonstrated microstructural and functional connectivity alterations in multiple cortical and thalamic regions and investigated glutamatergic and serotoninergic neurotransmission. These findings suggest that VSS might be a network disorder.

Only few treatment studies are currently available demonstrating limited response to medication and even worsening or triggering of visual symptoms by certain antidepressants. Promising nonpharmacological treatments include mindfulness-based cognitive therapy, the use of chromatic filters, and research on visual noise adaption and neuro-optometric visual rehabilitation therapy (NORT). However, the level of evidence is still low and further research is needed including larger trials and involving objective measures of individual dysfunction.


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