Optical Coherence Tomography in Patients with Chronic Migraine: Literature Review and Update

Neurovascular changes of the retina and optic nerve head in episodic migraine

To investigate neurovascular changes; including macular vascular density (VD), thickness of the ganglion cell layer (GCL) and optic nerve head (ONH) parameters in episodic migraine patients. 80 eyes of 40 episodic migraine patients were recruited. Thirty patients having a dominant side of migraine headache were statistically analyzed (5 male and 25 female; mean age 31.67 ± 9.54 years) and compared to 25 eyes of 25 healthy volunteers (5 male and 20 female; mean age of 34.4 ± 12.11 years, p = 0.361). The posterior segment was imaged with Topcon DRI optical coherence tomography (OCT) (Triton Swept source OCT Topcon, Japan), and OCT angiography (OCTA). Comparing the dominant side of migraine patients to controls we found a significant decrease of the VD in the central zone of the superficial and deep capillary plexus (SCP, p = 0.01; DCP, p = 0.004) and an enlarged foveal avascular zone (FAZ, p = 0.054). The GCL thickness was significantly reduced in the central ring (GCL + p = 0.042, GCL +  + p = 0.029), as well as the retinal nerve fiber layer (RNFL) thickness in the temporal quadrant (p = 0.021) and border tissue of Elschnig diameter (BTE, p = 0.035). The duration of migraine showed an inverse correlation with SCP in the nasal quadrant (p = 0.016, r = - 0.445) and with all DCP regions [DCP superior (p = 0.004, r = - 0.519), DCP inferior (p = 0.004, r = - 0.519), DCP nasal (p = 0.006, r = - 0.496), DCP temporal (p = 0.005, r = - 0.508), DCP CSF (p < 0.001, r = - 0.634)]. The dominant side compared to the non-dominant side showed a significant deterioration of the VD in the inferior (p = 0.04) and temporal quadrants (p = 0.023); furthermore, a significant decrease in the GCL +  + inner ring thickness (p = 0.046). Microvascular damage and consequent structural alterations of the retina and optic nerve head occur in the eyes of episodic migraine patient in association with the lateralization of the headache.

Retinal neural tissue and vascular calibres in migraine: the Northern Finland Birth Cohort Eye Study

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.

Optical coherence tomography findings in primary headache disorders: is pain duration a clinical correlate?

OBJECTIVE

Ganglion cell layer thickness (GCLT) may be used as a potential marker for central neural changes. We compared GCLT by using spectral domain optical coherence tomography (SD-OCT) in patients with primary headache disorders and healthy controls. We seek whether there was any difference between the headache groups and whether any clinical parameters correlated to GCLT.

METHODS

Fifty-three primary headache patients, 11 age and sex-matched healthy subjects were included in this cross-sectional study after power analysis. All subjects underwent SD-OCT. The duration of disorder, headache frequency, severity, duration of pain, presence of ocular pain, and accompanying symptoms have been collected.

RESULTS

Mean GCLT of the headache group was 15.7 ± 3.8 µm (mean ± standard deviation), and the control group was 17.5 ± 2.4. The difference was not statistically significant. When we compared the controls, migraine and tension-type headache patients' GCLT values, we found a significant difference (ANOVA, p = 0.001). Migraine patients had thinner GCLT compared to all non-migraine headache patients (p = 0.01). Intraocular pressure values of migraine patients and non-migraine patients were not statistically significantly different (p = 0.13). The only clinical parameter that correlated with GCLT was pain duration (r = -0.43 and p = 0.01). The patients with white matter lesions had thinner GCLT (p = 0.046).

CONCLUSION

Our results suggest that not long-term suffering from pain but migraine pathophysiology itself seems to affect neuroretinal tissue. Pain duration was moderately and inversely correlated to GCLT, meaning that the longer the headache, the thinner the ganglion cell layer is.

Using optical coherence tomography and optical coherence tomography angiography to delineate neurovascular homeostasis in migraine: a review

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.

Retinal and peripapillary vascular density in episodic and chronic migraine cases without aura

BACKGROUND

Migraine is a neurovascular disease that can cause ocular and systemic ischemic damage. Despite from aura, a limited number of studies have considered the effect of the chronic migraine in cases without aura. Our aim was to evaluate the differences in the retinal and optic disk microvasculature among episodic and chronic migraine cases without aura using optical coherence tomography angiography (OCTA) imaging.

METHODS

45 cases with migraine, and 25 control subjects were included in this prospective, cross-sectional study. OCTA was performed at 3 × 3 mm and 6 × 6 mm of the macula and at 4.5 × 4.5 mm of the optic disk. Retinal nerve fiber layer (RNFL) thickness, ganglion cell complex thickness, and vessel densities of the optic nerve and macula were compared among the three groups: a control group, an episodic migraine without aura (EMWOA) group, and a chronic migraine without aura (CMWOA) group.

RESULTS

In EMWOA group, circumpapillary vascular density (cpVD) was not decreased significantly in any quadrants (all, p>0.05). Compared to the control group, CMWOA group had significantly lower RNFL thickness in superior-temporal quadrants (p = 0.002 and 0.006, respectively), while cpVD differed only in the temporal quadrant and temporal inferior sector (p = 0.002 and p = 0.009, respectively).

CONCLUSIONS

Temporal peripapillary perfusion is valuable in the follow-up of chronic migraine cases. Longitudinal studies are needed to determine the place of OCTA in the follow-up of migraine.

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)

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.

The potential impact of migraine headache on retinal nerve fiber layer thickness

Background

Migraine is a common, chronic, multifactorial neurovascular disorder. It may result in hypoperfusion of other areas other than the brain, as the eye. It may lead to change of the retinal nerve fiber layers (RNFL) thickness and axonal loss even up to severe damage of the eye structures, including the retina with frequent headache attacks. This study aimed to quantify the thickness of RNFL which gives a good idea about the condition of axons and loss of ganglion cells in migraine patients. Also, to detect if there is any correlation between these measurements and clinical characteristics of migraine.

Results

The RNFL thickness was significantly thinner in patients with migraine compared to healthy controls in all quadrants of retina in both sides (p value < 0.05). However, there was no significant difference in RNFL thickness in migraine patients with aura compared to patients without aura in all retinal quadrants in both sides (p value > 0.05). The headache intensity was negatively correlated with RNFL thickness in the inferior (r = − 0.342, P = 0.031) and nasal (r = − 0.349, P = 0.027) quadrants on LT side, also there was a significant positive correlation between RNFL thickness and both of nausea and tolerability in the RT superior quadrant (r = 0.467, P = 0.002); (r = 0.322, P = 0.043), respectively, but there was no significant correlation found between the RNFL thickness and disability, attacks duration, disease duration and frequency in all retinal quadrants on both sides (P > 0.05).

Conclusion

The main conclusion of our work was that RNFL thickness was significantly affected in migraine patients in comparison to healthy controls, but there were no significant impact of the migraine characteristics including aura, severity, frequency, or duration of headache attacks on RNFL thickness.

Retinal Nerve Fiber Layer Analysis in Children With Migraine With and Without Aura Using Optical Coherence Tomography: A Case-Control Study

PURPOSE

To evaluate retinal nerve fiber layer (RNFL) thickness in children with migraine, with and without aura, compared to healthy controls using optical coherence tomography (OCT).

METHODS

In this cross-sectional case-control study, patients with a diagnosis of migraine with aura (MwA) or without aura (MwoA) were considered and healthy children were included as controls. Age, sex, duration of migraine, number of episodes per month, duration of episodes, and use of prophylactic treatment with magnesium were recorded. All patients underwent complete ophthalmologic, neurologic, and pediatric examination. Optic nerve OCT images were obtained using Heidelberg Spectralis OCT (Heidelberg Engineering) and mean global RNFL thickness and the average thickness for each sector were noted.

RESULTS

Thirty-seven children were included: 17 with migraine (9 MwoA and 8 MwA) and 20 controls, the mean age being 13.8 ± 2.9 (range: 8 to 16) and 13.4 ± 2.5 (range: 7 to 16) years, respectively. No significant differences in RNFL thickness were found when comparing all patients who had migraine with healthy controls. However, children with MwA showed statistically significant reductions in RNFL thickness in the temporal (mean difference: 7.83; 95% CI: 0.52 to 15.14, P = .027) and inferior-temporal (mean difference: 16.06; 95% CI: 1.95 to 30.16, P = .027) sectors compared to patients with MwoA. None of the other sectors showed statistically significant differences between groups (all P > .05). In the migraine group, negative correlations were detected between the number of episodes per month and RNFL thickness in the nasal-superior quadrant (r = -.420; P = .021).

CONCLUSIONS

Children with MwA may present a decrease in RNFL thickness, which is associated with the number of episodes per month. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

Status Migrainosus and Endometriosis: A Case Report and Review of the Literature

Status migrainosus is a migraine complication describing an attack lasting longer than 72 hours. In this paper, we present a case of a 34-year-old female with a history of severe endometriosis and hypercoagulable factor type II disease who presented to the emergency department (ED) with a three-week history of new-onset intractable migraine with aura. Imaging findings revealed a frontal T2/FLAIR hyperintensity, venous anomaly, and bilateral optic nerve thickening. The patient was admitted for three days of inpatient treatment with improvement of her symptoms.

Glaucoma and optical coherence tomography changes in migraine: A comparative cross-sectional study

Purpose

To study the prevalence of glaucoma among adults with migraine and the effect of migraine on peripapillary retinal nerve fiber layer (pRNFL) and central macular thickness (CMT) using optical coherence tomography (OCT) compared to those without migraine headache, i.e. in tension-type headache (TTH) and normal group.

Methods

One hundred and eleven patients (222 eyes) were recruited in three groups. migraine, TTH, and normal subjects visiting hospital outpatient services. After noting demographic details and pertinent history, ophthalmological evaluation including optic disc for glaucomatous changes along with computerized visual field testing and OCT for pRNFL thickness and CMT was performed in all eyes. Continuous variables were compared using ANOVA or Kruskal-Wallis test, while categorical variables including the association of glaucoma with migraine were analyzed using Chi-square or Fisher's exact test.

Results

Prevalence of glaucoma in migraine group (12.2%) was more than in comparison groups (6.8% in TTH, 4.1% in normal) which was however not significant (Fisher's exact P = 0.207). Average pRNFL thickness (103.59 ± 12.82 μm) and thickness in nasal (90.49 ± 19.19 μm) and temporal quadrants (70.58 ± 16.13 μm) and CMT (213.78 ± 19.81 μm) were significantly reduced (ANOVA P < 0.05) in migraine patients when compared to the other groups and this was independent of the presence of glaucoma.

Conclusion

Prevalence of glaucoma is not significantly higher in migraine patients. However, migraine causes thinning of retinal layers on OCT that is statistically significant.

Retinal Neurovascular Structural Changes in Optical Coherence Tomography and the Relationship between These Changes and White Matter Hyperintensities in Patients with Migraine

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.

Acute monocular oligemia in a patient with migraine with aura demonstrated using OCT-angiography: A case report

Introduction:

Migraine is one of the most common causes of transient visual loss. Optical coherence tomography angiography (OCTA) provides fast and non-invasive imaging of the retinal vessels. We report one case of monocular retinal oligemia demonstrated using OCTA during a migraine attack with aura.

Case description:

A 27-year-old man with a previous history of migraine with visual aura was seen in the emergency room due to acute left hemicranial pain with positive visual symptoms in his right eye. The patient reported a blue stain in his right eye. Optical coherence tomography angiography (OCT-A) showed an extensive area of hypoperfusion in the macular region of his right eye. Forty-eight hours later visual symptoms had improved and the OCT-A showed a significant reduction in the area of hypoperfusion. Seven days later the patient was asymptomatic and retinal perfusion had returned to normal values.

Conclusion:

Monocular involvement suggests that these retinal vascular changes are independent from cerebral vascular changes, supporting the hypothesis of selective retinal ganglion cell layer spreading depression as the possible cause of some cases of retinal migraine.

Retinal nerve fiber layer and ganglion cell layer changes using optical coherence tomography in patients with chronic migraine: a case-control study

Background

Migraine is a prevalent, chronic, and multifactorial neurovascular disease.

Objectives

Our work aimed to investigate if the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness are affected in patients with chronic migraine to improve the understanding of the etiology and pathophysiology of migraine.

Subjects and methods

A case-control study conducted on 30 patients with chronic migraine and 30 aged and sex-matched healthy controls. Subjects underwent full neurological and ophthalmological history, ophthalmological examination, and measuring RNFL and GCL thickness using the spectral domain-optical coherence tomography (SD-OCT).

Results

RNFL thinning (average, superior, inferior, nasal, and temporal) was significantly more in patients with chronic migraine than healthy control (P = 0.001, 0.022, 0.045, 0.034, and 0.001, respectively). No statistically significant difference was found between chronic migraine patients and healthy controls regarding GCL thickness (average, superior, and inferior) (P value ˃ 0.05).

The average RNFL thickness was significantly thinner in migraine with aura (MwA) than migraine without aura (MwoA) (P = 0.006). The average GCL thickness was thinner in MwA than MwoA (P = 0.039). No statistically significant difference was found between the eyes on the side of the headache and the eyes of the contralateral side regarding RNFL and GCL thickness (P value ˃ 0.05). Age at onset, disease duration, headache frequency, and headache intensity showed an insignificant correlation with OCT parameters.

Conclusion

Retinal changes could be an association with chronic migraine that may be used as a biomarker.

Retinal Nerve Fiber Layer Thickness and Oxidative Stress Parameters in Migraine Patients without Aura: A Pilot Study

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.

Topographic changes measured by the swept source optical coherence tomography in retinal nerve fiber layer, optic nerve head and macula in children with migraine

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.

Retinal correlates of neurological disorders

Considering the retina as an extension of the brain provides a platform from which to study diseases of the nervous system. Taking advantage of the clear optical media of the eye and ever-increasing resolution of modern imaging techniques, retinal morphology can now be visualized at a cellular level in vivo. This has provided a multitude of possible biomarkers and investigative surrogates that may be used to identify, monitor and study diseases until now limited to the brain. In many neurodegenerative conditions, early diagnosis is often very challenging due to the lack of tests with high sensitivity and specificity, but, once made, opens the door to patients accessing the correct treatment that can potentially improve functional outcomes. Using retinal biomarkers in vivo as an additional diagnostic tool may help overcome the need for invasive tests and histological specimens, and offers the opportunity to longitudinally monitor individuals over time. This review aims to summarise retinal biomarkers associated with a range of neurological conditions including Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and prion diseases from a clinical perspective. By comparing their similarities and differences according to primary pathological processes, we hope to show how retinal correlates can aid clinical decisions, and accelerate the study of this rapidly developing area of research.

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

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.

Principles of OCTA and Applications in Clinical Neurology

PURPOSE OF REVIEW

The article reviews the recent findings on the use of optical coherence tomography angiography (OCTA) in neurology.

RECENT FINDINGS

OCTA is a new addition to the powerful and complementary technology of the OCT. Due to its noninvasiveness, and reproducibility, it is possible to obtain high-resolution 3D images of the vessels of the human eye. As the vessels of the retina with the presence of endothelial cell's tight junctions resemble the brain vessels, it was hypothesized that the imaging of the retinal vessels might bring insight into brain vessels. OCTA has been effectively used to predict retinal vessel abnormalities in dementia, demyelization, optic disc neuropathies, and inherited degenerative diseases. Most common findings were decrease of vascular density and flow and an increase of avascular zones. Although OCTA is a relative new technology, recent studies show that it can be successfully applied in neurology.