Abstract
Abstract: :
Purpose: To evaluate 1. the frequency of migraine (MI) and family history (FH) of MI in patients with glaucoma (GL) or ocular hypertension (OH). 2. whether there is any difference in the frequency of MI in different types of GL compared to Normal Tension GL (NTG). 3. the frequency of MI in relation to the stage of visual field loss (VFL) in patients with Primary Open Angle GL (POAG) and NTG. Methods:By means of a questionnaire addressed to patients and their ophthalmologists, GL patients were interviewed using detailed standardized questions, concerning e.g. FH of GL (FHG), type of GL, stage of VFL, age at the time of diagnosis and potential risk factors, such as heart disease, vasospasm and migraine. Of 2027 patients who provided a yes or no answer on MI diagnosis, 1244 had POAG, 140 NTG, 49 pigmentary GL (PG), 64 PEX, 138 OH and 218 PACG. 174 patients had other types of GL, which are not evaluated here due to small sample sizes. Fisher’s exact test two–sided was used for statistics. Regarding the stage of VFL, we divided our patients into two groups, with no or beginning VFL (stages 0 – II, classification of Aulhorn) or moderate to severe VFL (stages III – V). Results: 1. Of 2027 patients, 13.7% (277) have MI. A FH of MI was reported by 30.8%, a FHG by 40.0%. Patients with FHG have a significantly higher frequency of MI than patients without FHG (15.7% vs. 12.3%, p = 0.0249) and are significantly younger. 2. The frequency of MI for POAG was 13.1%, NTG 21.4%, PG 24.5%, OH 13.8%, PEX 7.8% and PACG 10.1%. There was a significant difference between the MI frequency in POAG and NTG (13.1% vs. 21.4%, p = 0.0098), and between PEX and NTG (7.81% vs. 21.4%, p = 0.0166). There was no significant difference of MI in OH and NTG (13.7% vs. 21.4%, p = 0.1154), and between PACG and NTG (10.1% vs. 21.4%, p = 0.0035). 3. Of 76 NTG patients with VFL stages 0 – II, 21% and of 58 patients with stages III – V, 20.7% have MI. Of 964 POAG patients with stages 0 – II, 13.1% and of 259 patients with stages III – V, 12.7% have MI. There is no significant difference in the frequency of MI between patients with beginning compared to patients with severe VFL in POAG (p = 0.6077) and NTG ( p = 0.6025). Conclusions: The frequency of GL increases and of MI decreases with age. Inspite of no significant age difference between POAG and NTG patients, MI is significantly more frequent in NTG compared to POAG. This suggests an association of NTG and MI and a common, possibly polygenetic, vascular aetiology of these two diseases with familial predisposition. Regarding the extent of VFL in GL, MI is not a prognostic factor.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence