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Dianne A Barrett, Nafiseh Hashemi, Ore-Ofe O Adesina; Retinal Nerve Fiber Layer Thickness in Migraine and its Correlation to Duration and Severity of Disease. Invest. Ophthalmol. Vis. Sci. 2018;59(9):617.
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The blood supply of the optic nerve and retina are derived from the intracranial vasculature. Migraine-related vasospasm of the arterial vasculature supplying the retina and optic nerve head could cause ischemia and retinal nerve fiber loss. Several studies have investigated the retinal nerve fiber layer (RNFL) thickness in patients with migraine; however, no study has established a relationship between the severity or duration of migraine and RNFL thinning. This prospective, cross-sectional, case-control study is testing the hypothesis that RNFL thinning will be detected in migraine patients and correlate with migraine duration or severity.
31 migraine cases and 32 controls were enrolled. Migraine diagnosis was based on International Headache Society criteria. Cases completed the Migraine Disability Assessment (MIDAS) questionnaire, which asks a series of lifestyle questions to assess level of pain and disability due to migraine. It then assigns a score of I-mild to IV-severe. Exclusion criteria: ocular/neurologic pathology affecting the optic nerve/NFL, retinal disease, uveitis, intraocular pressure (IOP) ≥ 21 mmHg, axial length (AL) > 25 mm, intraocular surgery except cataract or refractive surgery and media opacity. Age and race matched non-migraine controls were recruited. Visual acuity, IOP, confrontation visual fields, motility and slit lamp exams were recorded. RNFL measurements were taken with spectral domain optical coherence tomography. Fundus photography and AL measurements were completed. Two-sample t-test and regression analysis were performed.
The superior macula was thinner in migraine participants compared to controls (P=0.026). There was no difference in average peripapillary RNFL or macular thickness in migraine compared to controls (P=0.36, P=0.82, respectively). A longer history of migraine correlated with a thinner temporal peripapillary RNFL (P=0.002). Less severe migraine (MIDAS I & II) had thinner average peripapillary RNFL compared to severe migraine (MIDAS III & IV, P=0.022).
Migraine was associated with retinal changes as measured by RNFL thinning in the superior macula. A longer history of migraine correlated strongly with thinner temporal peripapillary RNFL. There doesn’t appear to be an association between migraine severity and RNFL thickness as a higher MIDAS score did not correspond with a thinner RNFL.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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