Evaluation of the choroidal vascular index and choroidal changes in migraine subgroups

Torun, Isil Merve; Dikmen, Nejla Tükenmez; UNSAL, Mirac Aysen; Sonmez, Murat

doi:10.1016/j.pdpdt.2023.103348

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Aura migraineurs were likelier to have RNFL thinning than non-aura migraineurs, while most auras were visual ( Rasmussen and Olesen, 1992 ; Lin et al, 2021 ). Indeed, visual aura migraineurs had thinner RNFL than non-visual aura migraineurs in another study ( Torun et al, 2023 ). Aura migraineurs had RNFL thickening interictally but remaining thinner than controls ( El-Shazly et al, 2017 ).…”

Section: Retinamentioning

confidence: 91%

“…We found 26 studies assessing the choroid in migraineurs. In general, migraineurs have [often asymmetrically between eyes ( Khosravi et al, 2018 )] thinner choroids than controls ( Demircan et al, 2015 ; Zengin et al, 2015 ; Karaca et al, 2016 ; Ergiyit, 2017 ; Reggio et al, 2017 ; Khosravi et al, 2018 ), especially those with aura ( Ekinci et al, 2014 ; Karaca et al, 2016 ; Ao et al, 2019 ; Kanar et al, 2021 ; Gouravani et al, 2023 ; Torun et al, 2023 ). This may be more pronounced in the non-central choroid ( Abdellatif and Fouad, 2018 ).…”

Section: Choroidmentioning

confidence: 99%

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

Chaliha,

Vaccarezza,

Charng

et al. 2024

Front. Neurosci.

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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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Section: Retinamentioning

confidence: 91%

Section: Choroidmentioning

confidence: 99%

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

Chaliha,

Vaccarezza,

Charng

et al. 2024

Front. Neurosci.

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“…Variable results have been reported, possibly due to variability related to study design, populations studied, and differences in technical aspects of the studies owing to various OCT/OCTA machines used. Migraine with aura (MA) has been reported to be associated with a thinning of various retinal layers including the retinal nerve fiber layer, [25][26][27][28][29][30][31][32][33][34] ganglion cell layer, 30,35 choroid layer, 29,36 and increased size of the foveal avascular zone (FAZ). 37,38 Several studies have also investigated the retinal vasculature in the migraine population in the interictal state [38][39][40][41] using skeletonized or binarized OCTA derived measures (such as vessel area density [VAD] and vessel skeleton density [VSD]) and have shown a decrease in vascular density in various areas including foveal and parafoveal regions.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Reduction in retinal microvascular perfusion during migraine attacks

Podraza,

Bangera,

Feliz

et al. 2023

Headache

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ObjectiveTo determine if there are changes in structure and function of the retinal vasculature during and between migraine attacks using optical coherence tomography angiography (OCTA).BackgroundMigraine attacks commonly include visual symptoms, but the potential role of the retina in these symptoms is not well understood. OCTA is a rapid, non‐invasive imaging technique that is used to visualize the retinal microvasculature with high spatial resolution in a clinical setting. In this study we used OCTA to quantify different features of the retinal vasculature in patients with migraine during and between attacks, as well as in healthy controls (HCs).MethodsWe performed a prospective cohort study of 37 patients with migraine with aura (MA) (median [interquartile range, IQR] age of 37 [14] years, 86% female) and 30 with migraine without aura (MO) (median [IQR] age of 37 [17] years, 77% female) and 20 HCs (median [IQR] age of 35 [7] years, 50% female). Macular OCTA scans were obtained for all participants for the interictal analysis. In 12 MA and eight MO, scans were captured both during and outside of migraine attacks and five HCs had initial and repeat scans. In addition to analyzing the morphology of the foveal avascular zone, we calculated the vessel flux index (VFI), which is an indicator of retinal perfusion and conventional metrics (such as vessel area density) in the foveal and parafoveal regions.ResultsThere was a significant difference in the parafoveal VFI in the ictal state between the groups (p = 0.009). During migraine attacks there was a significant reduction in the parafoveal region VFI in MA (−7%, 95% confidence interval [CI] −10% to −4%; p = 0.006) and MO (−7%, 95% CI −10% to −3%; p = 0.016) from their interictal baseline as compared to the change between repeat scans in HCs (2%, 95% CI −3% to 7%). Interictally, there was a mean (standard deviation [SD]) 13% (10%) (p = 0.003) lower blood perfusion in the MA group as compared to the MO group in the foveal region (mean [SD] 0.093 [0.023] vs. 0.107 [0.021], p = 0.003). Interictal analysis also revealed higher circularity in the superficial foveal avascular zone in the MA group compared with the MO group (mean [SD] 0.686 [0.088] vs. 0.629 [0.120], p = 0.004). In addition, interictal analysis of the patients with MA or MO and unilateral headache showed increased retinal vascular parameters consistent with greater perfusion in the eye ipsilateral to the side of the pain as compared with the contralateral eye.ConclusionsThese results indicate that perfusion is reduced in MA and MO in the parafoveal retina during the ictal period. Interictally, the foveal retina in MA has reduced perfusion when compared to the foveal retina in MO. Patients with unilateral headache showed interictal asymmetry of retinal perfusion between eyes. These results indicate that changes in retinal perfusion could be a part of migraine pathophysiology, and that distinct retinal vascular signatures identified with OCTA could represent biomarkers for migraine.

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Letter to choroidal changes and the evaluation of the choroidal vascular index in migraine subgroups

Marino

Luca

Gioia

2023

Photodiagnosis and Photodynamic Therapy

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Evaluation of the choroidal vascular index and choroidal changes in migraine subgroups

Cited by 3 publications

References 28 publications

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

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

Reduction in retinal microvascular perfusion during migraine attacks

Letter to choroidal changes and the evaluation of the choroidal vascular index in migraine subgroups

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