Association of Meniere’s disease and retinal vascular calibre: a prospective observational study in China

Abstract

ObjectiveIt is believed that Meniere’s disease (MD) is associated with vascular disorders, but few studies have reported the relationship between retinal vascular disorders and MD. We evaluated and compared the retinal vascular calibres in patients with MD with healthy subjects matched for age, sex and vascular risk factors using retinal photographs to explore the association between MD and retinal vascular calibre.Study designA prospective study.SettingTertiary referral centre.ParticipantsSixty patients with MD and 62 healthy subjects matched for age, sex and vascular risk factors were enrolled in this study. Twenty-four patients with MD had migraines, and 36 patients with MD did not have migraines.Main outcome measureRetinal vascular calibres were calculated and compared not only between patients with MD and healthy subjects but also between subgroups of patients with MD.ResultsCompared with healthy subjects, patients with MD had a slightly larger retinal artery calibre (126.30±10.45vs 119.61±15.86, p=0.006) and a higher retinal artery/vein ratio (0.79±0.09vs 0.75±0.10, p=0.005). Among patients with MD, those with migraines had a larger retinal artery calibre (130.73±11.55vs 123.35±8.61, p=0.006) than those without migraines. Moreover, the presence of migraines and the high frequency of vertigo attacks appeared to increase the retinal artery calibre.ConclusionsOur study suggests that a relationship exists between retinal vascular calibre and MD. Although the pathophysiological relationship between migraine and MD remains unclear, the presence of migraine attacks may aggravate endolymphatic hydrops (EH) and accelerate the outflow of EH in patients with MD. More extensive studies are required to explore the association between retinal vascular calibre and MD.

A Comprehensive Update on Retinal Vasculitis: Etiologies, Manifestations and Treatments

“…Differentially, an activation of retinal vasculitis in the context of a checkpoint inhibitor therapy must be considered [146,147]. Furthermore, there are case reports of patients with ocular ischemic syndrome or retinitis pigmentosa and retinal partially occlusive vasculitis [148,149].…”

Meniere’s Disease

“…The diagnostic criteria for Meniere's disease has been revised by the Classification Committee of the Barany Society and resulted in 2 categories: Definitive Meniere's disease; two or more spontaneous vertigo attacks, each lasting 20 minutes to 12 hours, audiometric examination reveals low-to-moderate frequency fluctuation of sensorineural hearing loss in the affected ear at least 1 time before, during, or after one vertigo episode, fluctuating aural symptoms (hearing loss, tinnitus, or aural pressure) in the affected ear, other causes excluded by other tests. Possible Meniere's Disease; at least 2 episodes of vertigo or dizziness lasting 20 minutes to 24 hours, fluctuating aural symptoms (hearing loss, tinnitus, or aural pressure) in the affected ear, other causes excluded by other tests (4,6,(9)(10)(11). The diagnosis of Meniere's disease was made clinically.…”

The Association Between Choroidal Thickness and Meniere's Disease: A Cross‐Sectional Study

“…2,3 There are some studies supporting the role of vascular factors in the occurrence and progression of MD. 2,4 One of these studies has shown a slightly larger retinal artery caliber in patients with MD compared to matched healthy controls. 4 As the blood supply to the cochlea and retina is innervated by the ophthalmic branch of the trigeminal vascular system (TVS), 3,5,6 it has been hypothesized that the release of vasoactive neuropeptides from an active and sensitive TVS leads to inflammation and dilation of cochlear and retinal vasculature and subsequent aggravation of EH and increased retinal artery caliber.…”

“…2,4 One of these studies has shown a slightly larger retinal artery caliber in patients with MD compared to matched healthy controls. 4 As the blood supply to the cochlea and retina is innervated by the ophthalmic branch of the trigeminal vascular system (TVS), 3,5,6 it has been hypothesized that the release of vasoactive neuropeptides from an active and sensitive TVS leads to inflammation and dilation of cochlear and retinal vasculature and subsequent aggravation of EH and increased retinal artery caliber. 4 The choroid is an important vascular tissue supplying the metabolic needs of the outer layers of the retina and retinal pigment epithelium.…”

“…Although multiple contributing factors have been introduced as the etiology of MD, including endolymphatic hydrops (EH), autoimmunity, allergy, viral infection, genetics, and vascular disorders, the exact pathological mechanism is still unclear 2,3 . There are some studies supporting the role of vascular factors in the occurrence and progression of MD 2,4 . One of these studies has shown a slightly larger retinal artery caliber in patients with MD compared to matched healthy controls 4 .…”