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Chien-Chia Su; Migraine and the increased risk of developing open angle glaucoma: a population-based cohort study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3690.
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© ARVO (1962-2015); The Authors (2016-present)
Migraine is a neurovascular disorder of unknown etiology. In previous literature, migraine is associated with visual field progression in glaucoma subjects. Disturbances of autonomic activity during migraine attack may lead to alteration of ocular circulation and cause ganglion cell death. However, the association between migraine and open angle glaucoma is not determined. The purpose of our study is to investigate the association between migraine and the subsequent risk of open angle glaucoma (OAG) development after migraine diagnosis.
Patients with migraine aged ≥20 years were identified from the Taiwan National Health Insurance Research Database between 2000 and 2010. Each migraine patient was randomly matched to four subjects without migraine or other headache disorders based on age, sex, and index date. Patients with antecedent glaucoma at baseline year were excluded. Both cohorts were followed up until the end of 2010. The incidence rates of open angle glaucoma (OAG) were compared and risk factors were identified. The comorbid medical conditions for each subject were evaluated by using the established age-adjusted Charlson comorbidity index (ACCI). By using ACCI score, we further assess the hazard ratio for OAG in migraineurs with different level comorbidity. The Kaplan-Meier method was used to compute 10-year cumulative incidence rate of OAG.
A total of 18011 patients in the migraine cohort and 69132 patients in the matched control cohort were enrolled. The incidence rates per 1000 person-years of OAG among patients with migraine and the non-migraine controls were 1.29 and 1.02, respectively. Patients with migraine had significantly higher cumulative incidence rate than the matched cohort. (P= .021, log-rank test) The crude and adjusted HRs for patients with migraine versus comparison group with an ACCI score 0 were 1.73 (95% CI, 1.24-2.42) and 1.68 (95% CI, 1.20-2.36). For those patients with migraine versus comparison groups with an ACCI score 1-2 and with an ACCI score ≥3, the adjusted HRs were not significantly different. (P=.788 and P=.879, respectively)
This population-based study demonstrates that migraine is associated with an increased risk of OAG, particularly in patients with no comorbidity and aged under 50 years.
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