Evaluation of the retina and optic discs of patients with chronic and episodic migraine using optical coherence tomography and optical coherence tomography angiography

Abstract

Objective: Migraine is a very common, recurring, usually unilateral, severe, pulsating, and transient headache disorder, which causes temporary disability. Abnormal retinal and optic disc pathologies in migraine patients were previously reported by using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). In the present study, it was hypothesized that the changes found in the retina and optic disc might indicate a functional disorder in migraine. It is also emphasized that these changes might be useful for early diagnosis and follow-up of the disease, as well as for the development of new treatments.

Method: In total, 60 individuals were involved in the present study, including 28 chronic migraine patients (24 female, 4 male) and 32 episodic migraine patients (26 female, 6 male), whose migraine types were determined by using the criteria set by the International Headache Society (IHS) in 2013. The control group consisted of 48 healthy volunteers (34 female, 14 male) aged between 18 and 45 years, who applied to the ophthalmology clinic. The retinas and optic discs of the patients were examined by OCT and OCTA at our ophthalmology clinic. A double-blind randomized analysis was performed for the patient data and the data were compared to control group of similar gender and age.

Results: Examining the demographic data, no statistically significant difference was found between the migraine patients and the healthy controls in terms of age and gender However, using OCT, it was determined that the mean vertical and horizontal cup- to-disk (c/d) ratios at the optic disc were significantly impaired in patients compared to the control group. Moreover, using OCTA, significant reductions in vessel density were detected in the foveal, parafoveal, perifoveal areas and in the superficial and deep capillary plexuses of the patients.

Conclusion: Migraine patients have statistically significant differences in retinal thickness and vascularity, which is consistent with an increased risk.