Abstract
Purpose :
Current evaluation of photophobia relies on self-reported indicators (e.g., questionnaire surveys) with limited consideration from objective assessment indicators. Thus, the presence and severity of this condition may be underestimated. We aimed to validate the usefulness of self-reported sensitivity through questionnaire surveys and the objective assessment indicator of pupillary light reflex (PLR) in evaluating photophobia in patients with migraine.
Methods :
The study included 11 patients diagnosed with migraine based on the International Classification of Headache Disorders, 3rd edition, with an average age of 21.45±1.10 years (range: 20–24). Among them, one had migraine with aura, and ten had migraine without aura. A control group of 19 healthy individuals (mean age 21.47±0.51 years, range: 20–22) matched for age was used. The degree of photophobia was assessed using the Utah Photophobia Symptom Impact Scale-17 (UPSIS). Infrared electronic pupillometry (C10641: Hamamatsu Photonics) was employed for PLR measurements. Investigations were conducted during the interictal period ofAfter 5 min of dark adaptation, photopic stimuli of red (wavelength 635 nm) and blue light (wavelength 470 nm) were applied to the left eye for 10 s. Correlation analyses were conducted between UPSIS and parameters of the PLR.
Results :
UPSIS scores for the healthy group were 0–14 points (median [interquartile range] 7.0 [3.5–11.0]), while the migraine group scores were 10–49 points (median 27.0 [18.5–30.0]), showing a significantly higher value in the migraine group (p <0.001, Mann–Whitney U test). There was no observed correlation between UPSIS scores and various parameters of the PLR in the healthy group. In the migraine group, a statistically significant relationship existed between UPSIS and pupillary diameter (r = -0.65, p <0.05, Spearman's rank correlation coefficient) and velocity of pupillary dilation by blue light (r = -0.69, p <0.05, Spearman's rank correlation coefficient). This indicates the migraine patients with severe photophobia had a statistically significant relationship between the severity of photophobia symptoms and pupil diameter and having difficulty dilating in response to blue light stimuli.
Conclusions :
Adaptation occurs in response to photophobia in patients with migraine. PLR are useful in assessing the degree of photophobia in migraine patients.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.