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Anna Midelfart, Haakon Anders Bjurstrøm, Stig Rune Sollie, Erik Midelfart, Sven Midelfart; Visual field defects and retinal nerve fibre layer thickness measurements using optical coherence tomography in migraine patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4380.
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To measure retinal nerve fibre layer thickness (RNFLT) in eyes of migraine patients with optical coherence tomography (OCT) and examine relationship to visual field defects and length of migraine history.
Cross sectional study was performed among 20 patients with migraine with or without aura according to the criteria of the International Headache Society. They were examined by neurologist, general practitioner and ophthalmologist in relation to the inclusion criteria of the study. In all,16 patients (mean age 44 ±13 years, 4 men,12 women,length of migraine history 25 ±15 years) were included (32 eyes). Full-field 120 points screening perimetry out to 60 degrees from central fixation (Humphrey Field Analyzer) (n=16) was performed, and repeated if necessary. RNFLT was measured with OCT (Cirrus TM HD OCT) in each eye after pupillary dilation (n=14). All patients answered a questionnaire regarding history of migraine and subjective visual disturbances. The RNFLT for each subject was analysed in relation to the data of age corrected normal values within the OCT manufacturer database, and compared also to data obtained in a control group among subjects with normal vision and normal visual field (n=7; 14 eyes).
Among the 16 patients with migraine, 7 subjects (44%) had visual field defects, all of these outside central 30 degrees of fixation.The frequency of visual field defects was found to be significantly correlated with the length of migraine history (p= 0.011), but not with age (p=0.260). RNFLT was 84.2 ± 9.2 µm in the right eye and 82.2± 11.1 µm in the left eye among the patients with visual field defects (n=5, mean age 53.4 years, mean duration of migraine 38 years) compared to 95.1± 7.7 µm in the right eye and 98.3 ± 6.3 µm in the left eye among migraine patients with normal visual field (n=9, mean age 41.2 years, mean duration of migraine 18.2 years). The difference of RNFLT between these two groups was statistically significant in the left eye (p=0.027), (p=0.058 in the right eye). Specified, self-reported visual disturbances were not found to be correlated either with RNFLT (p= 0.538) nor with the frequency of detected visual field defects (p=0.343).
The average RNFLT is lower in migraine patients with a long history of migraine and is correlated with visual field defects.
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