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Chaliha DR, Vaccarezza M, Charng J, Chen FK, Lim A, Drummond P, Takechi R, Lam V, Dhaliwal SS, Mamo JCL. Using optical coherence tomography and optical coherence tomography angiography to delineate neurovascular homeostasis in migraine: a review. Front Neurosci 2024; 18:1376282. [PMID: 38686331 PMCID: PMC11057254 DOI: 10.3389/fnins.2024.1376282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/26/2024] [Indexed: 05/02/2024] Open
Abstract
Migraine is one of the world's most debilitating disorders, and it has recently been shown that changes in the retina can be a potential biomarker for the disease. These changes can be detected by optical coherence tomography (OCT), which measures retinal thickness, and optical coherence tomography angiography (OCTA), which measures vessel density. We searched the databases Google Scholar, ProQuest, Scopus, and Web of Science for studies in English using OCT and OCTA in migraineurs, using the search terms "optical coherence tomography," "OCT," "optical coherence tomography angiography," "OCTA" and "migraine." We found 73 primary studies, 11 reviews, and 8 meta-analyses pertaining to OCT and OCTA findings in migraineurs. They showed that migraineurs had reduced retinal thickness (via OCT), retinal vessel density, and greater foveal avascular zone area (via OCTA) than controls. OCTA changes reflect a perfusion compromise occurring in migraineurs as opposed to in healthy controls. OCT and OCTA deficits were worse in migraine-with-aura and chronic migraine than in migraine-without-aura and episodic migraine. Certain areas of the eye, such as the fovea, may be more vulnerable to these perfusion changes than other parts. Direct comparison between study findings is difficult because of the heterogeneity between the studies in terms of both methodology and analysis. Moreover, as almost all case-control studies were cross-sectional, more longitudinal cohort studies are needed to determine cause and effect between migraine pathophysiology and OCT/OCTA findings. Current evidence suggests both OCT and OCTA may serve as retinal markers for migraineurs, and further research in this field will hopefully enable us to better understand the vascular changes associated with migraine, perhaps also providing a new diagnostic and therapeutic biomarker.
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Affiliation(s)
- Devahuti R. Chaliha
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
| | - Mauro Vaccarezza
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Sciences (Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Sciences (Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Amy Lim
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA, Australia
| | - Peter Drummond
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Ryusuke Takechi
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
- Perron Institute Neurological and Translational Sciences, Perth, WA, Australia
| | - Virginie Lam
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
- Perron Institute Neurological and Translational Sciences, Perth, WA, Australia
| | - Satvinder S. Dhaliwal
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
- Singapore University of Social Sciences, Singapore, Singapore
| | - John C. L. Mamo
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
- Perron Institute Neurological and Translational Sciences, Perth, WA, Australia
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Akbarpour M, Jalali MM, Alizadeh Y, Nemati S, Akbari M, Dourandeesh M. The Association Between Choroidal Thickness and Meniere's Disease: A Cross-Sectional Study. Laryngoscope 2024; 134:1889-1893. [PMID: 37916786 DOI: 10.1002/lary.31136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/01/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To evaluate and compare choroidal thickness (CT) between patients with Meniere's disease (MD) and a control group. METHODS This case-control analytical study was conducted on 37 subjects with MD and 37 healthy subjects. Subfoveal CT (SCT), large choroidal vessel (LCV) layer thickness, and mean subfoveal LCV thickness/mean SCT ratio were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) in the eyes on the MD side (ipsilateral), the contralateral eyes, and the control group. RESULTS A statistically significant difference was observed in the mean SCT values between the ipsilateral and control groups after adjustment for age, sex, and migraine (p = 0.04). Moreover, there was a statistically significant difference between the mean subfoveal LCV thickness values and the mean subfoveal LCV thickness/mean SCT ratio between the ipsilateral and control groups (p = 0.006, and p < 0.001, respectively). Patients with a duration of disease over three years had a greater mean subfoveal LCV thickness/mean SCT ratio (67.35 ± 11.56 and 60.66 ± 11.27, respectively), which was statistically insignificant (p = 0.08). CONCLUSION We found a thicker choroid and Haller layer, and a greater subfoveal LCV thickness/SCT ratio on the MD side compared to the controls. Furthermore, patients with a greater duration of disease had a lower subfoveal LCV thickness/SCT ratio. These findings may reflect the role of the trigeminal vascular system (TVS) and neurovascular pathophysiology in MD patients. More extensive studies are required to reach more definitive conclusions about the association between CT and MD. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1889-1893, 2024.
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Affiliation(s)
- Maliheh Akbarpour
- Department of Otorhinolaryngology, School of Medicine, Otorhinolaryngology Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Mir Mohammad Jalali
- Department of Otorhinolaryngology, School of Medicine, Otorhinolaryngology Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Yousef Alizadeh
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Shadman Nemati
- Department of Otorhinolaryngology, School of Medicine, Otorhinolaryngology Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Mitra Akbari
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Dourandeesh
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Chaliha DR, Vaccarezza M, Corti E, Takechi R, Dhaliwal SS, Drummond P, Visser E, Chen FK, Charng J, Lam V, Mamo JC. L-arginine and aged garlic extract for the prevention of migraine: a study protocol for a randomised, double-blind, placebo-controlled, phase-II trial (LARGE trial). BMC Neurol 2023; 23:122. [PMID: 36973718 PMCID: PMC10041759 DOI: 10.1186/s12883-023-03149-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
Background Migraine is a common and distressing neurological condition characterised by recurrent throbbing headaches, nausea and heightened sensitivity to light and sound. Accumulating evidence suggests that cerebral arteries dilate during migraine, causing distal microvessels to constrict, which could activate nociceptors and cause onset of headache pain. If so, preventing or attenuating chronic microvascular constriction, and promoting a dilatory phenotype, may reduce frequency and/or severity of migraines. The primary aim of the L-Arginine and Aged Garlic Extract (LARGE) trial is to investigate whether oral treatment with dietary nutraceuticals, L-arginine and aged garlic extract (AGE), both systemic vasodilatory agents, will alleviate migraine frequency, duration and severity in adults with chronic frequent episodic migraines. Methods The study is a randomised double-blind placebo-controlled phase-II single-site clinical trial conducted in Perth, Australia. The target sample is to recruit 240 participants diagnosed with chronic frequent episodic migraines between 18 and 80 years of age. Participants will be randomised to one of four treatment groups for 14 weeks (placebo induction for 2 weeks, followed by 12 weeks on one of the respective treatment arms): placebo, L-arginine, AGE, or a combination of L-arginine and AGE. The doses of L-arginine and AGE are 1.5 g and 1 g daily, respectively. The primary outcome is to assess migraine response using change in migraine frequency and intensity between baseline and 12 weeks. Secondary outcomes include the impact of L-arginine and/or AGE on photosensitivity, retinal vessel changes, and blood biomarker concentrations of vascular tone, following a 12-week intervention. Discussion The protocol describes the oral administration of 2 nutraceutical-based interventions as possible prophylactic treatments for chronic frequent episodic migraines, with potential for direct clinical translation of outcomes. Potential limitations of the study include the fixed-dose design of each treatment arm and that in vivo neuroimaging methods, such as magnetic resonance imaging (MRI), will not be conducted to determine putative cerebro-vasodilatory changes to coincide with the outcome measures. Dose-response studies may be indicated. Trial registration The trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry ACTRN12621001476820 (Universal Trial Number: U1111-1268-1117) on 04/08/2021. This is protocol version 1, submitted on 25/11/2022. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-023-03149-y.
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Affiliation(s)
- Devahuti R. Chaliha
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Mauro Vaccarezza
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Emily Corti
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Ryusuke Takechi
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Satvinder S. Dhaliwal
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.4280.e0000 0001 2180 6431Duke-NUS Medical School, National University of Singapore, Queenstown, Singapore
- grid.11875.3a0000 0001 2294 3534Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
- grid.443365.30000 0004 0388 6484Singapore University of Social Sciences, 463 Clementi Road, Clementi, 599494 Singapore
| | - Peter Drummond
- grid.1025.60000 0004 0436 6763College of Science, Health, Engineering and Education (SHEE), Murdoch University, Murdoch, WA Australia
| | - Eric Visser
- grid.266886.40000 0004 0402 6494School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Fred K. Chen
- grid.1012.20000 0004 1936 7910Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, WA Australia
- grid.1008.90000 0001 2179 088XOphthalmology, Department of Surgery, The University of Melbourne, East Melbourne, VIC Melbourne, Australia
| | - Jason Charng
- grid.1012.20000 0004 1936 7910Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, WA Australia
- grid.1012.20000 0004 1936 7910Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA Australia
| | - Virginie Lam
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - John C.L. Mamo
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
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Evaluation of the choroidal vascular index and choroidal changes in migraine subgroups. Photodiagnosis Photodyn Ther 2023; 42:103348. [PMID: 36806697 DOI: 10.1016/j.pdpdt.2023.103348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Abstract
PURPOSE To investigate binarized choroidal structural parameters, retinal nerve fiber layer (RNFL) thickness, and retina changes duringattack-free periods in patients with migraine using enhanced depth imaging optic coherence tomography (EDI-OCT), and compare patients with migraine with aura and without aura (MwA and MoA, respectively) and aura subgroups (visual aura, non-visual aura), with age and sex-matched healthy subjects. METHOD This observational, prospective study included 102 patients with migraine and 36 healthy controls. Central macular thickness (CMT), retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and choroidal thickness (CT) were measured using a Spectralis OCT device. The choroid vascularity index (CVI) was evaluated using the Image-J software. CVI was calculated as the proportion of the luminal area (LA) to the total choroidal area (TCA). RNFL, CMT, CT, and CVI measurements were compared statistically. RESULTS Choroidal thickness at 1500 µm temporal of the fovea was found to be statistically significantly thinner in the MwA and MoA groups compared with the control group (p ≤ 0.01). There was a significant difference in the subfoveal CT values of the MwA and control groups (p < 0.05). The mean RNFL thickness of patients with migraine with visual aura was found to be statistically significantly thinner than in the migraine group with non-visual aura (98.73 ± 8.4 and 109.4 ± 16.8) (p < 0.05). There were no statistically significant differences between the RNFL CMT, GCC, and CVI values in the MwA, MoA, and control groups (p > 0.05). CONCLUSION We found that the choroidal thickness was significantly decreased in patients with migraine, especially in the MwA group. In the visual aura subgroup, the mean RNFL thickness was significantly decreased compared with the non-visual aura subgroup.
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Altunisik E, Oren B. Retinal Neurovascular Structural Changes in Optical Coherence Tomography and the Relationship between These Changes and White Matter Hyperintensities in Patients with Migraine. Eur Neurol 2021; 84:460-471. [PMID: 34515117 DOI: 10.1159/000518380] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/06/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aimed to reveal whether retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) inner plexiform layer, and choroidal layer (CL) thicknesses differed in patients with migraine. Optical coherence tomography (OCT) was used to measure these neurovascular structural changes and determine the relationship between these structures and cranial white matter hyperintensities (WMHs). METHODS This retrospective comparative registry study included a total of 155 individuals aged 18-55 (mean, 33.50 ± 8.34), consisting of 110 migraine patients and 45 healthy controls. RESULTS RNFLs were thinner in the migraine group than the control group but not to a statistically significant degree. However, in both eyes, peripapillary RNLF thickness in some specific quadrants was found to be significantly thinner in the patient group than the control group. GCLs were significantly thinner in the migraine group than the control group. CLs were significantly thicker in the migraine group than in the control group. There was no significant difference between the OCT parameters of patients with and without WMH. An inverse correlation was found between disease duration and CL thickness. CLs were significantly thicker in patients in attack periods than those in attack-free periods. There was no significant difference between the OCT parameters of the migraine with aura and migraine without aura subgroups. DISCUSSION/CONCLUSIONS Retinal neural and vascular structures might be affected in migraine sufferers, including those in subgroups. Rebound vasodilation may cause alterations in CL thickness during a migraine attack. Factors other than hypoperfusion may contribute to the pathophysiology responsible for the formation of WMH.
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Affiliation(s)
- Erman Altunisik
- Department of Neurology, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
| | - Burak Oren
- Department of Ophthalmology, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
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Karahan M, Erdem S, Ava S, Kaya AA, Demirtas AA, Keklikci U. Evaluation of retinal and optic nerve vasculature by optic coherence tomography angiography in Migraine with Aura. J Fr Ophtalmol 2021; 44:1396-1402. [PMID: 34364694 DOI: 10.1016/j.jfo.2021.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to evaluate the retina by optic coherence tomography angiography (OCTA) in patients with migraine with aura (MA) in comparison with healthy controls. MATERIALS AND METHODS A total of 60 patients with MA and 56 control subjects who applied to the Ophthalmology Clinic of Dicle University between January 2020 and February 2020 were included in this study. In all patients, the vascular density (VD) of the radial peripapillary capillaries (RPCs) and optic nerve head (ONH), the VD of deep and superficial macular vascular networks, and foveal avascular zone (FAZ) were measured. RESULTS Patients with MA showed reduced VD measurements of the nasal and inferotemporal ONH, inferonasal RPCs, and deep macular plexus. No statistically significant difference was observed in the superficial macular VD values between the study groups. The majority of patients with MA showed hypertrophy in the deep FAZ. CONCLUSION There was a decrease in VD measurements in the deep macular capillary plexus, ONH, and peripapillary capillaries and hypertrophy in the deep FAZ in patients with MA. According to these results, patients with MA may have an increased risk of developing ocular and systemic vascular complications. Therefore, OCTA can be used to evaluate systemic and ocular hypoperfusion in patients with MA.
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Affiliation(s)
- M Karahan
- Dicle University School of Medicine Department of Ophthalmology, 21280 Sur/Dıyarbakır, Turkey
| | - S Erdem
- Dicle University School of Medicine Department of Ophthalmology, 21280 Sur/Dıyarbakır, Turkey.
| | - S Ava
- Dicle University School of Medicine Department of Ophthalmology, 21280 Sur/Dıyarbakır, Turkey
| | - A A Kaya
- Hakkari State Hospital, Hakkari, Turkey
| | - A A Demirtas
- Health Sciences University, Tepecik Training and Research Hospital, Izmir, Turkey
| | - U Keklikci
- Dicle University School of Medicine Department of Ophthalmology, 21280 Sur/Dıyarbakır, Turkey
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Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010246. [PMID: 33396262 PMCID: PMC7795912 DOI: 10.3390/ijerph18010246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.
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Sekeryapan Gediz B, Ozturk M, Kilinc Hekimsoy H, Yuksel EG, Ozdamar Erol Y. Choroidal Vascularity Index as a Potential Inflammatory Biomarker for Obsessive Compulsive Disorder. Ocul Immunol Inflamm 2020; 30:428-432. [DOI: 10.1080/09273948.2020.1800052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Berrak Sekeryapan Gediz
- Ophthalmology Department, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ozturk
- Psychiatry Department, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Hilal Kilinc Hekimsoy
- Ophthalmology Department, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Emine Gokcen Yuksel
- Ophthalmology Department, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Yasemin Ozdamar Erol
- Ophthalmology Department, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Bulboacă AE, Stănescu IC, Bolboacă SD, Bulboacă AC, Bodizs GI, Nicula CA. Retinal Nerve Fiber Layer Thickness and Oxidative Stress Parameters in Migraine Patients without Aura: A Pilot Study. Antioxidants (Basel) 2020; 9:E494. [PMID: 32516927 PMCID: PMC7346136 DOI: 10.3390/antiox9060494] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Migraine is one of the most common disorders and its pathophysiological mechanisms are still under research, oxidative stress being emphasized as an important contributor. This study aimed to analyze the retinal nerve fiber layer (RNFL) thickness and oxidative/anti-oxidant balance in migraine patients. METHODS Two groups of subjects were evaluated: a group of patients with migraine and a control group of healthy volunteers. RNFL thickness was assessed for all subjects by the ocular coherence tomography spectral domain (OCT-SD). The oxidative stress parameter, namely nitric oxide (NOx), malondialdehyde (MDA), and total oxidative stress (TOS) were assessed. The antioxidant capacity of plasma was evaluated by assessing the level of catalase, and total anti-oxidative (TOS) capacity. Migraine severity was graded using the Migraine Disability Assessment Score (MIDAS) questionnaire. RESULTS All the oxidative stress parameters (NOx, MDA, and TOS) were significantly increased, and both parameters for anti-oxidative status were significantly decreased in the migraine group compared with the control group (p < 0.0001). Significant correlations with all the quadrants and different oxidative stress parameters were found, most involved being temporal quadrant. A significant positive correlation between catalase and macular RNFL thickness (inner ring, temporal quadrant) in migraine patients, for both eyes, was observed (p = 0.014 for the right eye and p = 0.12 for the left eye). CONCLUSION The assessment of the oxidative stress/anti-oxidative balance together with RFLN thickness can constitute a promising method to evaluate the progression of the diseases. It can also contribute to the estimation of the efficiency of various therapies targeting oxidative stress and associated inflammation.
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Affiliation(s)
- Adriana Elena Bulboacă
- Department of Pathophysiology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Ioana C. Stănescu
- Department of Neurology and Pediatric Neurology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Angelo C. Bulboacă
- Department of Neurology and Pediatric Neurology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | | | - Cristina A. Nicula
- Department of Ophthalmology, Iuliu Haţieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
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Topographic changes measured by the swept source optical coherence tomography in retinal nerve fiber layer, optic nerve head and macula in children with migraine. Acta Neurol Belg 2020; 120:661-668. [PMID: 30895457 DOI: 10.1007/s13760-019-01123-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 03/11/2019] [Indexed: 01/03/2023]
Abstract
As a vascular-inflammatory disease, migraine affects the brain and some other organs, such as the eye. The aim of this study was to measure and compare the peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell layer thickness and optic nerve head parameters to detect structural damage in children with migraine using swept-source optical coherence tomography. Twenty-four children with migraine in the painless period and 26 controls were included in the study. The vast majority of the groups consisted of females (75% for patients and 77% for controls). Certain RNFL quadrants and optic disc parameters revealed significant differences between the patients and controls. In the right and left eyes of children with migraine, nasal quadrant RNFL was significantly thicker than that in healthy subjects (88.82 ± 11.03 vs 77.80 ± 13.77, P = 0.004 for right eyes and 87.71 ± 11.79 vs 77.80 ± 13.77, P = 0.01 for left eyes). Temporal quadrant RNFL in the left eyes was thinner (78.67 ± 9.57 vs 84.44 ± 9.68, P = 0.04). Disc area in the left eyes of the patients was greater (2.29 ± 0.46 vs 1.94 ± 0.28, P = 0.003). There were significant expansions in cup volumes in favor of the patients for right and left eyes (0.15 ± .0.19 vs 0.05 ± 0.05, P = 0.03 and 0.17 ± 0.14 vs 0.05 ± 0.05, P = 0.001, respectively). The only significant difference between the left and right eyes of the migraineurs was the RNFL thickness in the superior quadrant. Ganglion cell layer thickness did not differ between the right eyes, left eyes and controls. In conclusion, children with migraine showed significant variations in specific RNFL and optic disc parameters compared to control subjects.
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Yener AÜ, Korucu O. Quantitative analysis of the retinal nerve fiber layer, ganglion cell layer and optic disc parameters by the swept source optical coherence tomography in patients with migraine and patients with tension-type headache. Acta Neurol Belg 2019; 119:541-548. [PMID: 30506164 DOI: 10.1007/s13760-018-1041-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/04/2018] [Indexed: 01/03/2023]
Abstract
The aim of the study was to measure the thicknesses of the inner retinal segments and optic nerve head (ONH) parameters in migraineurs and patients with tension-type headache (TTH) in headache-free period using swept source optical coherence tomography (SS-OCT) and to compare the outcomes with each other and those of healthy subjects. The study population consisted of 23 migraineurs, 22 TTH patients, and 25 controls with a best-corrected visual acuity of 20/20 and without a history of systemic or ocular disease. Macular ganglion cell inner plexiform layer (mGCIPL), macular ganglion cell complex (mGCC), circumpapillary retinal nerve fiber layer (cpRNFL), and ONH parameters were evaluated using SS-OCT, and the areas under the receiver-operating characteristic (ROC) curves were calculated to determine the ability of these parameters to distinguish between the patient and normal eyes. There were not statistically significant differences between the measurements acquired from migraineurs, TTH patients, and the controls. The outcomes of the patients with TTH were very similar to those of the normal participants. The areas under the ROC curves (AUC) correlated highly with the measurements obtained from the same subfields for the mGCC, MGCIPL, cpRNFL, and ONH parameters. In conclusion, SS-OCT presented reproducible and reliable measurements of posterior segment layers of the eyes, especially in sectoral configuration, and the parameters did not show significant difference between the groups.
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Affiliation(s)
- Arif Ülkü Yener
- Department of Ophthalmology, Keçiören Training and Research Hospital, Ankara, Turkey.
| | - Osman Korucu
- Department of Neurology, Keçiören Training and Research Hospital, Ankara, Turkey
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Abdellatif MK, Fouad MM. Effect of duration and severity of migraine on retinal nerve fiber layer, ganglion cell layer, and choroidal thickness. Eur J Ophthalmol 2018; 28:714-721. [DOI: 10.1177/1120672117750054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Purpose: To investigate the factors in migraine that have the highest significance on retinal and choroidal layers’ thickness. Methods: Ninety patients with migraine and 40 age-matched healthy participants were enrolled in this observational, cross-sectional study. After full ophthalmological examination, spectral domain-optical coherence tomography was done for all patients measuring the thickness of ganglion cell layer and retinal nerve fiber layer. Enhanced depth imaging technique was used to measure the choroidal thickness. Results: There was significant thinning in the superior and inferior ganglion cell layers, all retinal nerve fiber layer quadrants, and all choroidal quadrants (except for the central subfield) in migraineurs compared to controls. The duration of migraine was significantly correlated with ganglion cell layer, retinal nerve fiber layer, and all choroidal quadrants, while the severity of migraine was significantly correlated with ganglion cell layer and retinal nerve fiber layer only. Multiregression analysis showed that the duration of migraine is the most important determinant factor of the superior retinal nerve fiber layer quadrant (β = −0.375, p = 0.001) and in all the choroidal quadrants (β = −0.531, −0.692, −0.503, −0.461, −0.564, respectively, p < 0.001), while severity is the most important determinant factor of inferior, nasal, and temporal retinal nerve fiber layer quadrants (β = −0.256, −0.335, −0.308; p = 0.036, 0.005, 0.009, respectively) and the inferior ganglion cell layer hemisphere (β = −0.377 and p = 0.001). Conclusion: Ganglion cell layer, retinal nerve fiber layer, and choroidal thickness are significantly thinner in patients with migraine. The severity of migraine has more significant influence in the thinning of ganglion cell layer and retinal nerve fiber layer, while the duration of the disease affected the choroidal thickness more.
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Affiliation(s)
- Mona K Abdellatif
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed M Fouad
- Department of Neuropsychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Are there any changes in posterior ocular structure parameters in pediatric migraine patients? Eur J Ophthalmol 2017; 27:495-501. [PMID: 27834464 DOI: 10.5301/ejo.5000891] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the thickness of the peripapillary retinal nerve fiber layer (RNFL), total macula, macular ganglion cell layer (GCL), inner plexiform layer (IPL), and choroid in pediatric migraine patients and compare the values with healthy subjects. METHODS This observational and cross-sectional study included 40 patients in the migraine group and 40 healthy control subjects. The thickness of the peripapillary RNFL, total macula, GCL, and IPL was analyzed with spectral-domain optic coherence tomography, while choroidal thickness was analyzed with the enhanced depth imaging protocol. All measurements of the migraine patients were taken in the attack-free period. Right eye selected per subject was included in the study. RESULTS There was no significant difference between the 2 groups in age or sex (p>0.05). The peripapillary RNFL thickness was not significantly different between the 2 groups in any quadrant. The total macula, GCL, and IPL thickness were also not significantly different in the 9 separate macular areas defined on the basis of the Early Treatment Diabetic Retinopathy Study (p>0.05). The choroidal thickness at 5 different measurement points was not statistically significantly different between migraine patients during the attack-free period and the healthy subjects (p>0.05). CONCLUSIONS Childhood migraine does not cause changes in posterior ocular structure parameters.
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Unlu M, Sevim DG, Gultekin M, Baydemir R, Karaca C, Oner A. Changes in retinal vessel diameters in migraine patients during attack-free period. Int J Ophthalmol 2017; 10:439-444. [PMID: 28393037 DOI: 10.18240/ijo.2017.03.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/04/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the retinal vessel diameters in patients with migraine by optical coherence tomography (OCT). METHODS In this cross-sectional study, 124 eyes of 62 patients with a diagnosis of unilateral migraine during attack-free period and 42 age- and sex-matched control subjects were included. Migraine patients were divided into the ≤2 migraine attacks per month group and the ≥5 migraine attacks per month group. All subjects underwent complete ophthalmological and neurological examinations before measurements. Retinal vessel diameters and choroidal thickness were examined with the Spectralis OCT. RESULTS The mean diameters of the arteries in the eyes on the headache side of control group, ≥5 migraine attacks per month and ≤2 migraine attacks per month group at 480 µm from the optic disk (Raster 3) were 119.54±46.69, 136.68±25.93 and 119.34±31.75 µm respectively with a steady decline to 105.57±32.15, 118.18±31.87 and 108.05±38.77 µm at 1440 µm (Raster 7), the last measurement point, respectively. The retinal artery diameter measurements were significantly increased in ≥5 migraine attacks per month patients at four out of five measured points compared to control group (P<0.05). There were no statistical differences at any of the points of vein measurements. The choroidal thickness measurements were significantly decreased in ≥5 migraine attacks per month patients at all measured points compared to control group (P<0.05). CONCLUSION The retinal artery diameter is found to increase significantly and the choroidal thickness is found to decrease in the eyes on the headache side in ≥5 migraine attacks per month patients compared to control group.
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Affiliation(s)
- Metin Unlu
- Ophthalmology Department, School of Medicine, Erciyes University, Kayseri 38039, Turkey
| | - Duygu Gulmez Sevim
- Ophthalmology Department, School of Medicine, Erciyes University, Kayseri 38039, Turkey
| | - Murat Gultekin
- Neurology Department, School of Medicine, Erciyes University, Kayseri 38039, Turkey
| | - Recep Baydemir
- Neurology Department, School of Medicine, Erciyes University, Kayseri 38039, Turkey
| | - Cagatay Karaca
- Ophthalmology Department, School of Medicine, Erciyes University, Kayseri 38039, Turkey
| | - Ayse Oner
- Ophthalmology Department, School of Medicine, Erciyes University, Kayseri 38039, Turkey
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Advances in clinical neurology through the journal "Neurological Sciences" (2015-2016). Neurol Sci 2017; 38:9-18. [PMID: 28093657 DOI: 10.1007/s10072-017-2815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Choroidal thickness measurements in migraine patients during attack-free period. Neurol Sci 2016; 37:2025. [PMID: 27457657 DOI: 10.1007/s10072-016-2676-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
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