Abstract
Purpose: :
A former study evaluating more than 2000 glaucoma (GL) patients showed that patients with normal tension glaucoma (NTG) presented a history of migraine (MI) significantly more frequently than patients with other types of GL. The probability of an NTG patient to have MI was 63.5% higher than of a primary open angle GL patient of the same age (p = 0.0070 Cochran-Mantel-Haenszel statistics; OR 1.80 (95% CI 1.16-2.79)) (Gramer G: Familienanamnese, genetisches Risikoprofil und Risikofaktoren der Glaukome. Inauguraldissertation Med Fakultät, Universität Würzburg; 2006. http://www.opus-bayern.de/uni-wuerzburg/volltexte/2006/1997).Purpose of the present study was to re-evaluate in a further NTG cohort whether there is a correlation between the stage of visual field loss (VFL) and a history of MI.Do NTG patients with MI show more severe stages of VFL compared to NTG patients without MI?
Methods: :
Retrospective evaluation of the records of 89 patients with NTG who provided a "yes" or "no" answer about neurologically diagnosed MI in their history. Patients who did not provide precise information about MI in their history were not included in the evaluation.For staging of VFL, the eye with the more severe stage of VFL was used. If both eyes had the same stage of VFL, the selected eye was included at random.Perimetry was performed with Octopus Perimeter 101 and Goldman Perimeter.VFL was staged according to Aulhorn classification (stages I-V). Pre-perimetric glaucomas were defined as stage 0. For statistics, Jonckheere-Terpstra-Test was used.
Results: :
A history of MI was reported by 22 patients, whereas 67 patients did not have MI in their history.VFL was defined as stage 0 in 17 patients (19.1%), stage I in 9 patients (10.1%), stage II in 8 patients (9%), stage III in 42 patients (47.2%), stage IV in 8 patients (9%), and stage V in 5 patients (5.6%).There was a correlation between the presence of MI and a more severe stage of VFL (p= 0.026, Jonckheere-Terpstra-Test, two-sided).
Conclusions: :
The results suggest that NTG patients with MI have a higher risk of severe VFL than NTG patients without MI.NTG patients with MI should therefore undergo frequent perimetric follow-up, and their target IOP should be low. Further prospective long term studies with multifactorial analysis are required to confirm the results.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment