Migraine causes retinal and choroidal structural changes: evaluation with ocular coherence tomography

Reggio, Ester; Chisari, Clara Grazia; Ferrigno, Giulia; Patti, Francesco; Donzuso, Giulia; Sciacca, Giorgia; Avitabile, Teresio; Faro, Salvatore; Zappia, Mario

doi:10.1007/s00415-016-8364-0

Cited by 52 publications

(48 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…e authors also stated that the ocular pulse amplitude did not significantly differ between groups and concluded that although there was sectorial RNFL thinning in migraine patients without aura, the pulsative choroidal blood flow may not be affected during the chronic course of the disease. Reggio et al [21] reported significant thinning in RNFL, GCC, and choroidal in migraine patients compared with the healthy controls. Ao et al [22] found that the nasal peripapillary RNFL and inferior inner macular layer were significantly thinner in the migraine group with aura, but there was no difference between the two migraine groups and the control group.…”

Section: Discussionmentioning

confidence: 98%

Altered Macular Vasculature in Migraine Patients without Aura: Is It Associated with Ocular Vasculature and White Matter Hyperintensities?

Taşlı

Ersoy

2020

Journal of Ophthalmology

View full text Add to dashboard Cite

Aim. We aimed to determine the alterations in macular and optic nerve vasculature in patients with migraine without aura using optical coherence tomography-angiography (OCTA). We also aimed to determine whether there were clinical differences and alterations in ocular structures in migraine cases with white matter hyperintensities (WMH) using magnetic resonance imaging (MRI). Materials and Methods. The study group comprised patients with migraine without aura and age- and sex-matched healthy controls. Detailed histories of the patients with migraine were recorded including the disease duration, number of attacks in the last month, and attack durations. Visual evoked potentials (VEP) were recorded in all migraine patients. The migraine disability assessment (MIDAS) questionnaire was administered to all patients. The patients were divided into two groups as migraine with WMHs and migraine without WMHs. All subjects underwent a complete neurological and ophthalmological examination. Only the right eyes of the patients were included in the study. Retinal imaging was performed using OCT and OCTA. Results. A total of 66 migraine patients (29 with WMH and 37 without WMH) and 43 healthy controls were included in this study. Among the migraine patients, disease duration, attack frequency in the last month, attack durations, and the visual analogue scale (VAS), MIDAS, and VEP scores were all similar between those with and without WMHs. There was no significant difference between the groups regarding the ganglion cell complex, foveal, and retinal nerve fiber layer thicknesses. The superficial or deep vascular perfusion densities of the optic disc were also similar between the groups. The foveal avascular zone (FAZ) was significantly larger (P=0.034), and both superficial and deep macular vascular densities were significantly lower in the migraine groups compared with the healthy controls (P=0.001). There was no significant difference concerning the FAZ size or vascular densities between the migraine groups with and without WMHs. In the correlation analysis performed between the migraine patients, the FAZ size was correlated with age and VAS and MIDAS scores while both superficial and deep macular vascular densities were negatively correlated with age and VAS and MIDAS scores. Conclusion. We suggest that for not only migraine with aura but also migraine without aura, neurovascular structures play an important role in pathogenesis, and novel studies are warranted to elucidate the alterations in these and determine the significance of WMHs in these patient groups.

show abstract

Section: Discussionmentioning

confidence: 98%

Altered Macular Vasculature in Migraine Patients without Aura: Is It Associated with Ocular Vasculature and White Matter Hyperintensities?

Taşlı

Ersoy

2020

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…As for the frequency of migraine, some authors ( 18 , 59 ) did not find any correlation with the RNFL thickness, whereas others reported an inverse correlation between RNFL thickness and the total number of monthly migraine attacks ( 61 ).…”

Section: Optic Nerve Structural Changes In Migrainementioning

confidence: 99%

“…Migraine episodes may be linked to diminished blood flow in the retina and optic nerve, leading to irregular ocular perfusion and therefore to ischemia, which are implicated in the progression of glaucoma ( 32 ). The chronic nature of migraine, which is characterized by recurrent vasospasms and focal ischemia during attacks, could explain structural optic nerve damage, with the subsequent reduction in peripapillary RNFL thickness ( 61 ).…”

Section: Optic Nerve Structural Changes In Migrainementioning

confidence: 99%

“…Such discrepant results may be attributed to differences in methodology and sample size, ethnic variations, and the absence of standardized migraine characteristics, including severity, length of migraine history, and frequency of attacks ( 61 ). Feng et al ( 66 ) recently performed a meta-analysis of published case–control studies to explore changes in RNFL thickness in migraine patients assessed using OCT and reported lower peripapillary RNFL in patients with migraine than in healthy subjects.…”

Section: Optic Nerve Structural Changes In Migrainementioning

confidence: 99%

See 1 more Smart Citation

Optical Coherence Tomography in Patients with Chronic Migraine: Literature Review and Update

et al. 2017

View full text Add to dashboard Cite

Migraine is a chronic disease characterized by unilateral, pulsating, and often moderate-to-severe recurrent episodes of headache with nausea and vomiting. It affects approximately 15% of the general population, yet the underlying pathophysiological mechanisms are not fully understood. Optical coherence tomography (OCT) is a safe and reproducible diagnostic technique that utilizes infrared wavelengths and has a sensitivity of 8–10 μm. It can be used to measure thinning of the retinal nerve fiber layer (RNFL) in some neurological disorders. Although ophthalmologists are often the first specialists to examine patients with migraine, few studies have addressed the involvement of the optic nerve and retino-choroidal structures in this group. We reviewed the literature on the etiological and pathological mechanisms of migraine and the relationship between recurrent constriction of cerebral and retrobulbar vessels and ischemic damage to the optic nerve, retina, and choroid. We also assessed the role of OCT for measuring peripapillary RNFL thickness and macular and choroidal changes in migraine patients. There is considerable evidence of cerebral and retrobulbar vascular involvement in the etiology of migraine. Transitory and recurrent constriction of the retinal and ciliary arteries may cause ischemic damage to the optic nerve, retina, and choroid in patients with migraine. OCT to assess the thickness of the peripapillary RNFL, macula, and choroid might increase our understanding of the pathophysiology of migraine and facilitate diagnosis of retino-choroidal compromise and follow-up of therapy in migraine patients. Future studies should determine the usefulness of OCT findings as a biomarker of migraine.

show abstract

“… 12 Retinal vascular disorder has been reported in patients with migraine and is thought to result from activation of the trigeminal vascular system (TVS), which innervates the blood vessels of the eyes. 13 It has been demonstrated that the inner ear blood flow is also directly affected by the trigeminal nerve through innervation of cochlear vasculature. 14–16 We therefore hypothesised that retinal vascular disorders may exist in patients with MD due to the close relationship between MD and migraine.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

View full text Add to dashboard Cite

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.

show abstract

Migraine causes retinal and choroidal structural changes: evaluation with ocular coherence tomography

Cited by 52 publications

References 40 publications

Altered Macular Vasculature in Migraine Patients without Aura: Is It Associated with Ocular Vasculature and White Matter Hyperintensities?

Altered Macular Vasculature in Migraine Patients without Aura: Is It Associated with Ocular Vasculature and White Matter Hyperintensities?

Optical Coherence Tomography in Patients with Chronic Migraine: Literature Review and Update

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

Contact Info

Product

Resources

About