Abstract
Purpose :
To examine the associations between migraines and subtypes of glaucoma using data from the 2019 California (CA) Medicare population.
Methods :
The study population included 2019 CA Medicare beneficiaries aged 65 years or older with Parts A and B coverage and one or more Part B claims. Primary outcomes include a diagnosis of any glaucoma (including glaucoma suspects), primary open angle glaucoma (POAG), and normal tension glaucoma (NTG) defined by the International Classification of Diseases, 10th revision, clinical modification (ICD-10-CM) codes. The primary exposures were a diagnosis of migraine headaches and ophthalmoplegic migraines/recurrent painful ophthalmoplegic neuropathy (OM), based on ICD-10-CM codes. Multivariable logistic regression models examined the relationship between each migraine and glaucoma type, after adjusting for age, sex at birth, race and ethnicity, and Charlson Comorbidity Index score.
Results :
Overall, a total of 2,717,346 CA Medicare beneficiaries met the inclusion criteria, 411,099 (15.1%) of whom had any glaucoma/glaucoma suspect. Of the study population, 162,096 (6.0%) had POAG, 13,600 (0.50%) had NTG, 51,809 (1.9%) had migraines, and 1,870 (0.07%) had OM. Compared to those without migraines, those with migraines had increased odds of having any glaucoma (adjusted odds ratio [aOR]: 1.46; 95% confidence interval [CI]: 1.43-1.50, p<0.001), POAG (aOR: 1.23; 95% CI: 1.19-1.28, p<0.001), and NTG (aOR: 1.68; 95% CI: 1.52-1.86, p<0.001). Compared to those without migraines, those with OM had increased odds of having any glaucoma (aOR: 2.18; 95% CI: 1.96-2.41, p<0.001), POAG (aOR: 1.69; 95% CI: 1.44-1.98, p<0.001), and NTG (aOR: 2.63; 95% CI: 1.74-3.97, p<0.001).
Conclusions :
Among the 2019 CA Medicare population, migraines were associated with increased likelihood of having multiple types of glaucoma, with the strongest association occurring between OM and NTG. Future studies should assess whether a common vasculopathic or neuropathic etiology may contribute to these two conditions. These results suggest that individuals with migraines and OM may benefit from early ophthalmology referral and glaucoma screening.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.