CGRP Inhibitors Reduce Glaucoma Risk Compared to Traditional Migraine Preventives

Migraine is increasingly understood as a systemic disorder with microvascular consequences, including an elevated risk for retinal vascular events and various maculopathies [1]. While traditional oral preventive medications like topiramate and divalproex are widely used, their clinical utility can be limited by tolerability issues and inconsistent evidence on long-term systemic safety [2]. The development of therapies targeting the calcitonin gene-related peptide (CGRP) pathway has significantly altered the management of both episodic and chronic migraine, offering high specificity and a favorable safety profile [3, 4]. Given that CGRP is a potent vasodilator active in both nociceptive and vascular pathways, its long-term inhibition raises important questions about ocular hemodynamics and the risk of comorbid conditions like glaucoma [5]. A recent multinational cohort study provides new data clarifying the association between these targeted inhibitors and the risk of incident glaucoma.