{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:04:42Z","timestamp":1791857082683,"version":"4.3.4"},"reference-count":35,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Warsaw for the cost of publication"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: Visual snow (VS) is a rare clinical entity in neuro-ophthalmology. It is described as the presence of flickering dots affecting the whole visual field, often compared by patients to snow or pixelated television static. Importantly, it can be an alarming symptom for many patients, lowering their quality of life. Our purpose is to increase awareness of this disease, because many healthcare professionals have difficulty identifying symptoms as the nature of the condition is subjective. In this review, we aimed to describe the updates in the etiology and treatment of visual snow. We searched for articles in English, presenting original data and published after December 2019. Different studies show inconsistent data. Neuroimaging studies found, among other things, hypermetabolism of the lingual gyrus, increased gray matter in different brain areas, and altered connectivity in visual pathways. However, these findings were not present in all patients. According to the literature, among the most effective drugs is lamotrigine. Unfortunately, it also carries a risk of worsening the symptoms. It is crucial to remember that VS can be worsened or induced by alcohol, recreational drugs, and certain medication. In terms of treatment, nonpharmacological approaches such as color filters and repetitive Transcranial Magnetic Stimulation were also used. Interpretation: Further studies are needed to understand the nature of VS fully. Even though the pathophysiology and effective treatment of the condition remains unknown, expanding the knowledge about visual snow can impact the comfort of patients.<\/jats:p>","DOI":"10.3390\/jcm12123868","type":"journal-article","created":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T02:08:15Z","timestamp":1686017295000},"page":"3868","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Visual Snow: A Review on Pathophysiology and Treatment"],"prefix":"10.3390","volume":"12","author":[{"given":"Przemys\u0142aw","family":"Rusztyn","sequence":"first","affiliation":[{"name":"Students\u2019 Scientific Club, Department of Ophthalmology, Medical University of Warsaw, 02-005 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiktoria","family":"Sta\u0144ska","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Club, Department of Ophthalmology, Medical University of Warsaw, 02-005 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6057-6740","authenticated-orcid":false,"given":"Anna","family":"Torbus","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Club, Department of Ophthalmology, Medical University of Warsaw, 02-005 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6725-6332","authenticated-orcid":false,"given":"Piotr","family":"Maciejewicz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Warsaw, 02-005 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/WCO.0000000000000523","article-title":"Visual snow syndrome: What we know so far","volume":"31","author":"Puledda","year":"2018","journal-title":"Curr. Opin. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000508602","article-title":"Visual Snow: A Case Series from Israel","volume":"11","author":"Berkowitz","year":"2020","journal-title":"Case Rep. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s11910-018-0854-2","article-title":"Visual Snow Syndrome: Proposed Criteria, Clinical Implications, and Pathophysiology","volume":"18","author":"Metzler","year":"2018","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11916-015-0497-9","article-title":"Visual Snow\u2014Persistent Positive Visual Phenomenon Distinct from Migraine Aura","volume":"19","author":"Schankin","year":"2015","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1093\/brain\/awu050","article-title":"\u2018Visual snow\u2019\u2014A disorder distinct from persistent migraine aura","volume":"137","author":"Schankin","year":"2014","journal-title":"Brain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1111\/ene.14914","article-title":"Migraine prevalence in visual snow with prior illicit drug use (hallucinogen persisting perception disorder) versus without","volume":"28","author":"Alderliefste","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"CNC89","DOI":"10.2217\/cnc-2021-0003","article-title":"Visual snow syndrome: Evolving neuro-optometric considerations in concussion\/mild traumatic brain injury","volume":"6","author":"Ciuffreda","year":"2021","journal-title":"Concussion"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"646","DOI":"10.3988\/jcn.2020.16.4.646","article-title":"Neuro-ophthalmologic Findings in Visual Snow Syndrome","volume":"16","author":"Yoo","year":"2020","journal-title":"J. Clin. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/WNO.0000000000000702","article-title":"Visual Snow: Visual Misperception","volume":"38","author":"White","year":"2018","journal-title":"J. Neuro-Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Barral, E., Silva, E.M., Garc\u00eda-Azor\u00edn, D., Viana, M., and Puledda, F. (2023). Differential Diagnosis of Visual Phenomena Associated with Migraine: Spotlight on Aura and Visual Snow Syndrome. Diagnostics, 13.","DOI":"10.3390\/diagnostics13020252"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/bs.pbr.2020.05.020","article-title":"Insights into pathophysiology and treatment of visual snow syndrome: A systematic review","volume":"255","author":"Eren","year":"2020","journal-title":"Prog. Brain Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"582031","DOI":"10.3389\/fnhum.2020.582031","article-title":"Abnormal Connectivity and Brain Structure in Patients with Visual Snow","volume":"14","author":"Aldusary","year":"2020","journal-title":"Front. Hum. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"658857","DOI":"10.3389\/fneur.2021.658857","article-title":"Magnetic Suppression of Perceptual Accuracy Is Not Reduced in Visual Snow Syndrome","volume":"12","author":"Eren","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"738599","DOI":"10.3389\/fneur.2021.738599","article-title":"Delayed Onset of Inhibition of Return in Visual Snow Syndrome","volume":"12","author":"Foletta","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"697923","DOI":"10.3389\/fneur.2021.697923","article-title":"Short-Wave Sensitive (\u201cBlue\u201d) Cone Activation Is an Aggravating Factor for Visual Snow Symptoms","volume":"12","author":"Hepschke","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"fcab296","DOI":"10.1093\/braincomms\/fcab296","article-title":"Cortical oscillatory dysrhythmias in visual snow syndrome: A magnetoencephalography study","volume":"4","author":"Hepschke","year":"2021","journal-title":"Brain Commun."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1111\/ene.14903","article-title":"White matter abnormalities in a patient with visual snow syndrome: New evidence from a diffusion tensor imaging study","volume":"28","author":"Latini","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"723805","DOI":"10.3389\/fneur.2021.723805","article-title":"Widespread White Matter Alterations in Patients with Visual Snow Syndrome","volume":"12","author":"Michels","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1792","DOI":"10.1212\/WNL.0000000000010530","article-title":"Occipital cortex and cerebellum gray matter changes in visual snow syndrome","volume":"95","author":"Puledda","year":"2020","journal-title":"Neurology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/acn3.50986","article-title":"Insular and occipital changes in visual snow syndrome: A BOLD fMRI and MRS study","volume":"7","author":"Puledda","year":"2020","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1136\/jnnp-2020-325881","article-title":"Localised increase in regional cerebral perfusion in patients with visual snow syndrome: A pseudo-continuous arterial spin labelling study","volume":"92","author":"Puledda","year":"2022","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1002\/hbm.25343","article-title":"Disrupted connectivity within visual, attentional and salience networks in the visual snow syndrome","volume":"42","author":"Puledda","year":"2021","journal-title":"Hum. Brain Mapp."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"811490","DOI":"10.3389\/fneur.2022.811490","article-title":"Case Report: Transformation of Visual Snow Syndrome From Episodic to Chronic Associated With Acute Cerebellar Infarct","volume":"13","author":"Puledda","year":"2022","journal-title":"Front. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/brain\/awaa053","article-title":"Structural and functional footprint of visual snow syndrome","volume":"143","author":"Schankin","year":"2020","journal-title":"Brain"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1177\/0333102420950454","article-title":"[123 I]-IMP single-photon emission computed tomography imaging in visual snow syndrome: A case series","volume":"40","author":"Shibata","year":"2020","journal-title":"Cephalalgia"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e1784","DOI":"10.1212\/WNL.0000000000010372","article-title":"Ocular motor measures of visual processing changes in visual snow syndrome","volume":"95","author":"Solly","year":"2020","journal-title":"Neurology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"9607","DOI":"10.1038\/s41598-021-88788-2","article-title":"Eye movement characteristics provide an objective measure of visual processing changes in patients with visual snow syndrome","volume":"11","author":"Solly","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"fcac164","DOI":"10.1093\/braincomms\/fcac164","article-title":"Microstructure in patients with visual snow syndrome: An ultra-high field morphological and quantitative MRI study","volume":"4","author":"Strik","year":"2022","journal-title":"Brain Commun."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/OPX.0000000000001862","article-title":"Case Report: Visual Snow Syndrome after Repetitive Mild Traumatic Brain Injury","volume":"99","author":"Werner","year":"2022","journal-title":"Optom. Vis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"395","DOI":"10.4149\/BLL_2020_064","article-title":"Can repetitive transcranial magnetic stimulation of the visual cortex ameliorate the state of patients with visual snow?","volume":"121","author":"Grey","year":"2020","journal-title":"Bratisl. Med. J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/head.14118","article-title":"A case of visual snow treated with phenylephrine","volume":"61","author":"Coleman","year":"2021","journal-title":"Headache"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1136\/bjophthalmol-2020-318653","article-title":"Evaluation of treatment response and symptom progression in 400 patients with visual snow syndrome","volume":"106","author":"Puledda","year":"2021","journal-title":"Br. J. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"724081","DOI":"10.3389\/fneur.2021.724081","article-title":"A Study Protocol for an Open-Label Feasibility Treatment Trial of Visual Snow Syndrome With Transcranial Magnetic Stimulation","volume":"12","author":"Grande","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.pediatrneurol.2021.08.005","article-title":"Onset of Visual Snow Syndrome After the First Migraine Episode in a Pediatric Patient: A Case Report and Review of Literature","volume":"126","author":"Guay","year":"2022","journal-title":"Pediatr. Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/WNF.0000000000000512","article-title":"Probable Methylphenidate-Related Reversible \u201cVisual Snow\u201d in a Child With ADHD","volume":"45","author":"Naguy","year":"2022","journal-title":"Clin. Neuropharmacol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/12\/3868\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:48:59Z","timestamp":1760125739000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/12\/3868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,6]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["jcm12123868"],"URL":"https:\/\/doi.org\/10.3390\/jcm12123868","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,6]]}}}