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. Migraine has two main types: with aura and without aura. 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 suggested that the changes foundin the retina and optic disc mightindicate a functional disorder in chronic (with and without aura) and episodic (with and without aura) 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, 16 with aura, 12 without aura) and 32 episodic migraine patients (26 female, 6 male, 21 with aura, 11 without aura), who were diagnosed with migraine and whose migraine types were determinedby 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 optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) at our ophthalmology clinic. A double-blind randomized analysis was performed for the patient data and the data were compared to control group data of similar gender and age groups. Results: Examining the demographic data, no statistically significant difference was found between the migraine patients and the healthy controls in terms of age, gender, migraine history, and migraine type. However, using Optical Coherence Tomography (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 Optical Coherence Tomography Angiography (OCTA), significant reductions in vessel density (VD) were detected in the foveal, parafoveal, perifoveal areas and in the superficial and deep capillary plexuses (SCP and DCP) of the patients. Conclusion: It is thought that these findings might be associated with a vasculopathy developing due to a pathology in the autonomic nervous system or impairments in the cerebral, ocular, or systemic circulation. The authors believe that the results achieved in the present study could be useful in the diagnosis, monitoring, and treatment of the disease.