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Ristioja S, Leiviskä IL, Saarela VO, Liinamaa MJ. Retinal neural tissue and vascular calibres in migraine: the Northern Finland Birth Cohort Eye Study. Acta Ophthalmol 2024; 102:600-609. [PMID: 38146656 DOI: 10.1111/aos.16617] [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: 07/20/2023] [Revised: 11/26/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE To evaluate the possible effects of migraine on retinal nerve fibre layer (RNFL), ganglion cell-inner plexiform layer (GC-IPL), macular thickness and retinal arteriolar and venular diameters (CRAE, CRVE) in a population-based birth cohort. METHODS 375 migraineurs and 1489 healthy controls were included in this cross-sectional cohort study. RNFL, GC-IPL and macular thickness parameters were measured by spectral domain optical coherence tomography (OCT), and vascular parameters were measured from fundus photographs. Migraine was determined by a questionnaire and specific features were selected as covariates (gender, smoking status, systolic blood pressure, refraction and diabetes). RESULTS There were no statistically significant differences between healthy controls and migraineurs in average RNFL (p = 0.123), macular (p = 0.488) or GC-IPL (p = 0.437) thickness. Migraine did not have a significant effect on any of the macular or GC-IPL subfields. For RNFL subfields, only temporal inferior was borderline significantly increased in migraineurs (p = 0.039) in adjusted results. No statistically significant differences were found between study groups on retinal vascular calibres CRAE (p = 0.879), CRVE (p = 0.145) or AVR (p = 0.259). GC-IPL thickness was found to be positively correlated with CRAE and CRVE in both study groups as GC-IPL thickness increased together with the increase in CRAE and CRVE (p-trend < 0.001 in both), and a similar trend was detected with central macular subfield thickness and systolic (p-trend < 0.001) and diastolic (p-trend = 0.010) blood pressure, but only in the control group. CONCLUSION There were no remarkable differences between migraineurs and healthy controls in retinal vascular or structural parameters in our study.
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Affiliation(s)
- Salla Ristioja
- Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
- MRC Oulu, Oulu, Finland
- Research Unit of Clinical Medicine University of Oulu, Oulu, Finland
| | - Ilmari L Leiviskä
- Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
- MRC Oulu, Oulu, Finland
- Research Unit of Clinical Medicine University of Oulu, Oulu, Finland
| | - Ville O Saarela
- Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
- MRC Oulu, Oulu, Finland
- Research Unit of Clinical Medicine University of Oulu, Oulu, Finland
| | - M Johanna Liinamaa
- Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
- MRC Oulu, Oulu, Finland
- Research Unit of Clinical Medicine University of Oulu, Oulu, Finland
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Udomwech L, Sulastiwaty R, Siriarchawawat D. Migraine eye: correlation between migraine and the retina. PeerJ 2024; 12:e17454. [PMID: 38818459 PMCID: PMC11138520 DOI: 10.7717/peerj.17454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/03/2024] [Indexed: 06/01/2024] Open
Abstract
Background Activation of the trigeminal vascular system in migraine releases vasoactive neurotransmitters, causing abnormal vasoconstriction, which may affect the ocular system, leading to retinal damage. The purpose of our study was to determine whether there are differences in each retinal layer between migraine patients and healthy subjects. Methods A case-control study recruited 38 migraine patients and 38 age- and sex-matched controls. Optical coherence tomography was used to measure the thickness of the peripapillary and macular retinal nerve fiber layer (pRNFL and mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL). Results The mean ages of the migraine patients and controls were 36.29 ± 9.45 and 36.45 ± 9.27 years, respectively. Thirty-four patients (89.48%) in both groups were female. The mean disability score was 19.63 ± 20.44 (indicating severe disability). The superior-outer INL of migraine patients were thicker than controls. Thickness of the GCL at temporal-outer sector and mRNFL at the superior-outer sector of the headache-side eyes was reduced. However, the INL of the headache-side-eye showed negative correlation with the disability score. This is the first study having found thinning of the GCL and mRNFL of the headache-side eyes. The INL was also thickened in migraines but showed negative correlation with the disability score. Conclusions Increased INL thickness in migraine patients may result from inflammation. The more severe cases with a high disability score might suffered progressive retinal neuronal loss, resulting in thinner INL than less severe cases.
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Affiliation(s)
- Lunla Udomwech
- Department of Ophthalmology, School of Medicine, Walailak University, Thasala, Nakhonsithammarat, Thailand
| | | | - Doungkamol Siriarchawawat
- Division of Neurology, Department of Internal Medicine, School of Medicine, Walailak University, Thasala, Nakhonsithammarat, Thailand
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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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Zhao Y, Zhao J, Gu Y, Chen B, Guo J, Xie J, Yan Q, Ma Y, Wu Y, Zhang J, Lu Q, Liu J. Outer Retinal Layer Thickness Changes in White Matter Hyperintensity and Parkinson's Disease. Front Neurosci 2021; 15:741651. [PMID: 34594186 PMCID: PMC8477009 DOI: 10.3389/fnins.2021.741651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/18/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose: To investigate the thickness changes of outer retinal layers in subjects with white matter hyperintensities (WMH) and Parkinson's Disease (PD). Methods: 56 eyes from 31 patients with WMH, 11 eyes from 6 PD patients, and 58 eyes from 32 healthy controls (HC) were enrolled in this study. A macular-centered scan was conducted on each participant using a spectral-domain optical coherence tomography (SD-OCT) device. After speckle noise reduction, a state-of-the-art deep learning method (i.e., a context encoder network) was employed to segment the outer retinal layers from OCT B-scans. Thickness quantification of the outer retinal layers was conducted on the basis of the segmentation results. Results: WMH patients had significantly thinner Henle fiber layers, outer nuclear layers (HFL+ONL) and photoreceptor outer segments (OS) than HC (p = 0.031, and p = 0.005), while PD patients showed a significant increase of mean thickness in the interdigitation zone and the retinal pigment epithelium/Bruch complex (IZ+RPE) (19.619 ± 4.626) compared to HC (17.434 ± 1.664). There were no significant differences in the thickness of the outer plexiform layer (OPL), the myoid and ellipsoid zone (MEZ), and the IZ+RPE layer between WMH and HC subjects. Similarly, there were also no obvious differences in the thickness of the OPL, HFL+ONL, MEZ and the OS layer between PD and HC subjects. Conclusion: Thickness changes in HFL+ONL, OS, and IZ+RPE layers may correlate with brain-related diseases such as WMH and PD. Further longitudinal study is needed to confirm HFL+ONL/OS/IZ+RPE layer thickness as potential biomarkers for detecting certain brain-related diseases.
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Affiliation(s)
- Yitian Zhao
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.,Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.,Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Jinyu Zhao
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.,School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Yuanyuan Gu
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.,Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.,Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Bang Chen
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Jiaqi Guo
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Jianyang Xie
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Qifeng Yan
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Yuhui Ma
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Yufei Wu
- The Affiliated People's Hospital of Ningbo University, Ningbo, China
| | - Jiong Zhang
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Qinkang Lu
- The Affiliated People's Hospital of Ningbo University, Ningbo, China
| | - Jiang Liu
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, China
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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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Kwapong WR, Gao Y, Yan Y, Zhang Y, Zhang M, Wu B. Assessment of the outer retina and choroid in white matter lesions participants using swept-source optical coherence tomography. Brain Behav 2021; 11:e2240. [PMID: 34291589 PMCID: PMC8413737 DOI: 10.1002/brb3.2240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 05/07/2021] [Accepted: 05/23/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To assess the three-dimensional outer retina thickness and choroid in eyes with white matter lesions (WMLs) using swept-source optical coherence tomography (SS-OCT). METHODS Participants without dementia and stroke with cerebral WMLs were enrolled in our study. Optical coherence tomography (OCT) and OCT angiography (OCTA) were used to image and evaluate the outer retinal layer, choroidal structure, and perfusion of the choriocapillaris, microvessels of the choroid, respectively. Measurement of the outer retinal thickness, choroidal thickness and perfusion of the choriocapillaris was done by the SS-OCT tool. RESULTS Thirty-one eyes from 16 WMLs and 40 eyes from 20 healthy controls were included in the data analyses. Outer retinal thickness was significantly reduced (P < .001) in WMLs participants when compared to healthy controls. Choroidal thickness was also significantly reduced (P < .001) in WMLs participants when compared to healthy controls. Choriocapillaris perfusion was significantly reduced (P = .002) in WMLs when compared to healthy controls. A significant correlation (Rho = .392, P = .032) was seen between the outer retinal thickness and choriocapillaris perfusion in WMLs participants. CONCLUSIONS Assessing retinal thickness and choroidal changes with the SS-OCTA as a proxy for WML could prove to be a potentially valuable tool for early detection of cognitive decline and other neurodegenerative diseases.
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Affiliation(s)
| | - Yuzhu Gao
- Department of Ophthalmology, West China Hospital, Sichuan University, Sichuan, China
| | - Yuying Yan
- Department of Neurology, West China Hospital, Sichuan University, Sichuan, China
| | - Yifan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Sichuan, China
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Sichuan, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Sichuan, China
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Kanar HS, Toz HT, Penbe A. Comparison of retinal nerve fiber layer, macular ganglion cell complex and choroidal thickness in patients with migraine with and without aura by using optical coherence tomography. Photodiagnosis Photodyn Ther 2021; 34:102323. [PMID: 33962058 DOI: 10.1016/j.pdpdt.2021.102323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/24/2021] [Accepted: 04/30/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND We compared the choroidal thickness (CT), peripapillary retinal nerve fibre layer thickness (pRNFLT) and macular ganglion cell complex thickness (mGCCT) by using spectral domain optic coherence tomography (SD-OCT) in patients with migraine with aura (MWA), migraine without aura (MWoA), and healthy controls. METHODS Thirty-seven patients with MWA, 40 patients with MWoA, and age and sex-matched 50 healthy controls were included in this cross-sectional study. CTs at fovea, nasal to fovea and temporal to fovea, global pRNFLT, four quadrants of pRNFLTs, mGCCTs in superior and inferior hemisphere were measured by SD-OCT. The duration of migraine, monthly attack number and the migraine disability assessment (MIDAS) questionnaire scores were recorded. RESULTS The mean foveal CT, nasal CT, and temporal CT in patients with MWA were significantly thinner than those of patients with MWoA and control (p < 0.001) while CTs of patients with MWoA were similar with those of controls. Patients with MWA and MWoA had thinner global pRNFLT, superior and inferior pRNFLT compared to controls but there were no significant differences between two migraineurs groups. Only nasal quadrant of pRNFLT was significantly thinner in patients with MWA than other groups. The superior and inferior mGCCTs were significantly thinner in patients with MWA and MWoA than controls. CONCLUSION Our results suggested that dysregulation of blood flow in ocular tissues caused by impairment of autoregulation in migraine. Patients with MWA might have an additional risk of choroidal and retinal ischemia than patients with MWoA and healthy controls.
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Affiliation(s)
- Hatice Selen Kanar
- Health Science University, Kartal Dr. Lutfi Kirdar Trainig and Research HospItal, Department of Ophthalmology, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No:47, 34865 Kartal, Istanbul, Turkey.
| | - Hilal Tastekin Toz
- Health Science University, Kartal Dr. Lutfi Kirdar Trainig and Research Hospital, Department of Neurology, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No:47, 34865 Kartal, Istanbul, Turkey.
| | - Aysegul Penbe
- Health Science University, Kartal Dr. Lutfi Kirdar Trainig and Research HospItal, Department of Ophthalmology, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No:47, 34865 Kartal, Istanbul, Turkey.
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Coppola G, Di Lorenzo C, Di Lenola D, Serrao M, Pierelli F, Parisi V. Visual Evoked Potential Responses after Photostress in Migraine Patients and Their Correlations with Clinical Features. J Clin Med 2021; 10:jcm10050982. [PMID: 33801187 PMCID: PMC7957878 DOI: 10.3390/jcm10050982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 11/16/2022] Open
Abstract
In the past few years, researchers have detected subtle macular vision abnormalities using different psychophysical experimental tasks in patients with migraine. Recording of visual evoked potential (VEP) after photostress (PS) represents an objective way to verify the integrity of the dynamic properties of macular performance after exposure to intense light. VEPs were recorded before and after PS in 51 patients with migraine (19 with aura (MA) and 22 without aura (MO) between attacks, and 10 recorded during an attack (MI)) and 14 healthy volunteers. All study participants were exposed to 30 s of PS through the use of a 200-watt bulb lamp. The P100 implicit time and N75-P100 amplitude of the baseline VEP were compared with those collected every 20 s up to 200 s after PS. VEP parameters recorded at baseline did not differ between groups. In all groups, the VEP recordings exhibited a significant increase in implicit times and a reduction in amplitude at 20 s after the PS. In migraine, the percentage decrease in amplitudes observed at 20 s after photostress was significantly lower than in healthy volunteers, in both MO and MA patients, but not in MI patients. When data for MO and MA patients were combined, the percentage of amplitude change at 20 s was negatively correlated with the number of days that had elapsed since the last migraine attack, and positive correlated with attack frequency. We showed dynamic changes of recovery of VEP after PS depending on the migraine cycle. This finding, in conjunction with those previously attained with other neuromodulatory interventions using VEPs, leads us to argue that migraine-disease-related dysrhythmic thalamocortical activity precludes amplitude suppression by PS.
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Affiliation(s)
- Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
- Correspondence: ; Tel.: +39-0773-6513337; Fax: +39-0773-651230
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
| | - Davide Di Lenola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
- IRCCS—Neuromed, Headache Center, Via Atinense 18, 86077 Pozzilli, IS, Italy
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Retinal nerve fiber layer changes in migraine: a systematic review and meta-analysis. Neurol Sci 2021; 42:871-881. [PMID: 33439389 DOI: 10.1007/s10072-020-04992-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/11/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Migraine is one of the most common disabling diseases in the world. Its recurrent attacks may lead to abnormalities in the structure of the brain and retina. An increasing number of studies have investigated retinal nerve fiber layer (RNFL) thickness alterations in migraine by the optical coherence tomography (OCT); however, no consensus has yet reached. METHOD We searched Pubmed, Embase, and Web of Science databases to identify studies that investigated RNFL thickness in migraine by OCT measurement and performed a meta-analysis of eligible studies. RESULTS Twenty-six studies were included in the meta-analysis, comprising 1530 migraine patients and 1105 healthy controls. The mean RNFL thickness was thinner in the migraine group compared to the control group (SMD =- 0.53). In the subgroup analyses, RNFL thickness were decreased most significantly in the superior (SMD = - 0.71) and inferior (SMD = - 0.63) quadrants among all quadrants. Migraine with aura (SMD = - 0.91) showed a greater effect size of RNFL thickness reduction than migraine without aura (SMD =- 0.47). Spectral-domain OCT (SMD = - 0.55) seems more sensitive to detect RNFL thickness reduction than time-domain OCT (SMD = - 0.44). In addition, age, sex, disease duration, attack frequency, and intraocular pressure were not significantly associated with RNFL thickness. CONCLUSIONS The findings from our comprehensive meta-analysis with large datasets strengthen the clinical evidence of the RNFL thickness reduction in migraine. RNFL thickness via spectral-domain OCT measurement demonstrates the potential role in differentiating patients with migraine, especially migraine with aura, from healthy controls.
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Peng C, Kwapong WR, Xu S, Muse FM, Yan J, Qu M, Cao Y, Miao H, Zhen Z, Wu B, Han Z. Structural and Microvascular Changes in the Macular Are Associated With Severity of White Matter Lesions. Front Neurol 2020; 11:521. [PMID: 32714262 PMCID: PMC7344221 DOI: 10.3389/fneur.2020.00521] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/12/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose: This study aimed to characterize the microvascular and structural changes in the macular that occur in white matter hyperintensities (WMH) using optical coherence tomographic angiography. We also aimed to explore the association between macular microvascular and structural changes with focal markers of brain tissue on MRI in WMH using the Fazekas scale. Methods: This study enrolled healthy participants who were stroke- and dementia-free. MRI was used to image the cerebral white matter lesions, and Fazekas scale was used to evaluate the severity of the white matter lesions. Optical coherence tomography angiography (OCT-A) was used to image the radial peripapillary capillaries (RPCs), macular capillary plexuses [superficial capillary plexus (SCP) and deep capillary plexus (DCP)] and thickness around the optic nerve head, peripapillary retinal nerve fiber layer (pRNFL). Results: Seventy-four participants were enrolled and divided into two groups according to their Fazekas score (Fazekas scores ≤ 1 and ≥2). Participants with Fazekas score ≥2 showed significantly reduced RPC density (P = 0.02) and DCP density (P = 0.012) when compared with participants with Fazekas score ≤ 1. Participants with Fazekas score ≥2 showed reduced pRNFL (P = 0.004) when compared to participants with Fazekas score ≤ 1. Fazekas scores were significantly associated with the pRNFL thickness (Rho = −0.389, P = 0.001), RPC density (Rho = −0.248, P = 0.035), and DCP density (Rho = −0.283, P = 0.015), respectively. Conclusions: Microvascular impairment and neuro-axonal damage are associated with the disease cascade in WMH. We have shown that RPC and DCP densities are significantly affected, and these impairments are associated with the severity of the disease and cognitive function. OCT-A could be a useful tool in quantifying the retinal capillary densities in WMH.
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Affiliation(s)
- Chenlei Peng
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | | | - Shasha Xu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Farah Mohamed Muse
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jueyan Yan
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Man Qu
- Taizhou Central Hospital, Taizhou University Hospital, Zhejiang, China
| | - Yungang Cao
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hanpei Miao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Zhenxiang Zhen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bo Wu
- West China Hospital, Sichuan University, Sichuan, China
| | - Zhao Han
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Qu M, Kwapong WR, Peng C, Cao Y, Lu F, Shen M, Han Z. Retinal sublayer defect is independently associated with the severity of hypertensive white matter hyperintensity. Brain Behav 2020; 10:e01521. [PMID: 31875660 PMCID: PMC7010590 DOI: 10.1002/brb3.1521] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/31/2019] [Accepted: 12/02/2019] [Indexed: 01/16/2023] Open
Abstract
PURPOSE To investigate the association of specific retinal sublayer thicknesses on optical coherence tomography (OCT) imaging with brain magnetic resonance imaging (MRI) markers using the Fazekas scale in hypertensive white matter hyperintensity (WMH) subjects. METHODS Eighty-eight participants (32 healthy controls and 56 hypertensive white matter hyperintensity subjects) underwent retinal imaging using the OCT and MRI. A custom-built algorithm was used to measure the thicknesses of the retinal nerve fiber layer (RNFL) and ganglion cell layer and inner plexiform layer (GCIP). Focal markers for white matter hyperintensities were assessed on MRI and graded using the Fazekas visual rating. RESULTS Hypertensive WMH showed significantly reduced (p < .05) RNFL and GCIP layers when compared to healthy controls, respectively. A significant correlation was found between the RNFL (ρ = -.246, p < .001) and GCIP (ρ = -.338, p < .001) of the total participants and the Fazekas score, respectively. Statistical differences were still significant (p < .05) when correlations were adjusted for intereye correlation, age, hypertension, smoking, body mass index, and diabetes. Among the cases of hypertensive WMH, higher Fazekas scores were significantly associated (p < .05) with the thinning of both the RNFL and GCIP layers after adjustment of age and other risk factors. CONCLUSIONS Retinal degeneration in the RNFL and GCIP was independently associated with focal lesions in the white matter of the brain and deteriorates with the severity of the lesions. We suggest that imaging and measurement of the retinal sublayers using the OCT may provide evidence on neurodegeneration in WMH.
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Affiliation(s)
- Man Qu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | | | - Chenlei Peng
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yungang Cao
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Meixiao Shen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Zhao Han
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Chen XY, Chen ZY, Dong Z, Liu MQ, Yu SY. Regional volume changes of the brain in migraine chronification. Neural Regen Res 2020; 15:1701-1708. [PMID: 32209774 PMCID: PMC7437590 DOI: 10.4103/1673-5374.276360] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The pathophysiology of migraine is complex. Neuroimaging studies reveal functional and structural changes in the brains of migraine patients. We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine. Sixteen episodic migraine patients, 16 chronic migraine patients, and 24 normal controls were recruited and underwent 3.0 T MRI scanning. The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables. Results demonstrated that the volumes of specific regions in the frontal and occipital lobes, and the right putamen, were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls. The volumes of the left basal forebrain, optic chiasm, and, the fourth ventricle were decreased in the chronic migraine patients, while the occipital cortex and the right putamen were larger. Compared to episodic migraine patiants, chronic migraine patients displayed larger left thalamus and smaller frontal regions. Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole, right lateral orbital gyrus, and medial frontal lobes and positively correlated with the volume of the left thalamus. The sleep disturbance score was negatively correlated with the volume of the left basal forebrain. This suggests that migraine patients have structural changes in regions associated with pain processing and modulation, affective and cognitive processing, and visual perception. The remodeling of selective intracranial structures may be involved in migraine attacks. This study was approved by the Ethics Committee of Chinese PLA General Hospital (approval No. S2018-027-02) on May 31, 2018.
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Affiliation(s)
- Xiao-Yan Chen
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Ye Chen
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing; Department of Radiology, Hainan Hospital of First Medical Center of Chinese PLA General Hospital, Sanya, Hainan Province, China
| | - Zhao Dong
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Meng-Qi Liu
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing; Department of Radiology, Hainan Hospital of First Medical Center of Chinese PLA General Hospital, Sanya, Hainan Province, China
| | - Sheng-Yuan Yu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
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Retinal vascular density evaluation of migraine patients with and without aura and association with white matter hyperintensities. Acta Neurol Belg 2019; 119:411-417. [PMID: 30762208 DOI: 10.1007/s13760-019-01094-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/05/2019] [Indexed: 12/23/2022]
Abstract
Underlying pathophysiological mechanism of migraine is not all clear; however, recent reports suggested that neurovascular system is involved. We aimed to evaluate the retinal vessel densities of migraine patients with and without aura and the associations with white matter hyperintensities (WMH), using optical coherence tomography angiography (OCTA). We recruited 28 migraine with aura (MWA) patients, 26 migraine without aura (MWO) and age and sex-matched 34 healthy controls in our study. All participants were evaluated with optical coherence tomography (OCT) and OCTA for optic nerve parameters and retinal vessel densities with RTVue XR AVANTI. On macular OCTA, superficial and deeper retinal foveal vessel density (VD) were significantly lesser in MWA and MWO than controls. On optic nerve OCTA, whole optic disc, peripapillary, superior hemisphere, superior layer and temporal layer VD were significantly lesser in MWA and MWO. In group of MWA with the WMH, deeper foveal VD and superior hemisphere VD, average RNFL, superior hemisphere and superior layer were significantly lesser and also foveal avascular zone was significantly larger than the group of without WMH. Alterations of VD in patients with migraine are showed in our study. In addition, in group of MWA these alterations have associations with WMH. Supporting these findings with further reports can be useful to understand the pathophysiology of this disease.
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Tak AZA, Şengül Y, Ekmekçi B, Karadağ AS. Comparison of optic coherence tomography results in patients with diagnosed epilepsy: Findings in favor of neurodegeneration. Epilepsy Behav 2019; 92:140-144. [PMID: 30658322 DOI: 10.1016/j.yebeh.2018.12.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 12/17/2018] [Accepted: 12/22/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Epilepsy is a chronic neurological disease characterized with recurrent seizures. Progressive neuronal degeneration is a common consequence of long-term and/or recurrent seizure activity in epilepsy. Optical coherence tomography (OCT) is a new medical imaging technique that displays biological tissue layers as high-resolution tomographic sections. The aim of our study was to evaluate OCT findings in patients with epilepsy and to compare OCT findings in terms of disease duration, presence of status, seizure frequency, and drug use. METHODS Forty-three patients who had epilepsy according to the Commission on Classification and Terminology of the International League Against Epilepsy (ILAE) in 2010 and 40 healthy controls were recruited for the study. Disease duration, seizure frequency, status history, and multiple drug use were noted. Retinal nerve fiber layer (RNLF), ganglion cell layer (GCL), inner-plexiform layer (IPL), and choroid thinning were analyzed by using spectral OCT. RESULTS The mean RNFL values are 101.48 ± 11.33 in the patient group and 108.76 ± 8.37 in the control group (p = 0.001). The mean GCL thickness values in the patient and control groups are 1.14 ± 0.12 and 1.22 ± 0.05, (p < 0.001). The mean IPL thickness is 0.93 ± 0.09 in the patient group and 0.97 ± 0.05 in the control group (p = 0.02). Choroid thickness is significantly increased in the patient group (p < 0.001). CONCLUSIONS Demonstration of RNFL, IPL, and GCL thinning might indicate neurodegeneration, and choroid thickening indicates neuroinflammation. We found no association between disease duration, seizure frequency, status history, and multiple drug use and OCT parameters. Further studies with larger patient groups should clarify the matter.
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Affiliation(s)
- Ali Zeynal Abidin Tak
- Adıyaman University, School of Medicine, Department of Neurology, Siteler Mahallesi, Atatürk Bulvarı, No: 411, Adiyaman, Turkey.
| | - Yıldızhan Şengül
- Bezmialem Vakif University Hospital, Department of Neurology, Adnan Menderes Bulvarı, Vatan Caddesi, 34093 Fatih, İstanbul, Turkey
| | - Burcu Ekmekçi
- Antalya Atatürk State Hospital, Department of Neurology Antalya, Anafartalar Cad. Üçgen Mevkii Muratpaşa, Antalya, Turkey
| | - Ayşe Sevgi Karadağ
- Adıyaman University, School of Medicine, Department of Ophthalmology, Siteler Mahallesi, Atatürk Bulvarı, No: 411, Adiyaman, Turkey
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