Risk of Retinal Artery Occlusion in Patients with Migraine

Al-Moujahed, Ahmad; Tran, Elaine; Azad, Amee D.; Vail, Daniel; Ludwig, Cassie A.; Pasricha, Malini Veerappan; Rosenblatt, Tatiana R.; Callaway, Natalia F.; Moshfeghi, Darius M.

doi:10.1016/j.ajo.2020.11.004

Cited by 16 publications

(12 citation statements)

References 52 publications

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“…The headache is preceded by aura symptoms, usually visual disturbances, in a third of migraine sufferers (4). For many years, migraine has been thought to be associated with a variety of ophthalmic diseases, such as central retinal artery and vein occlusions, anterior and posterior ischemic optic neuropathy, and normal-tension glaucoma (5)(6)(7)(8). One study showed that 24% of patients with retinal arterial occlusions had a history of migraine (9).…”

Section: Introductionmentioning

confidence: 99%

Analysis of macular microvasculature with optical coherence tomography angiography for migraine: A systematic review and meta-analysis

Yu²,

Liu³

et al. 2022

Front. Neurol.

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ObjectiveThis study aimed to evaluate the features of macular microvasculature with optical coherence tomography angiography (OCTA) among migraine patients.MethodsWe systematically searched PubMed, Web of Science, Embase, and Cochrane Library for studies that evaluated the macular microvasculature of migraine patients. The weighted mean differences (WMDs) of the foveal avascular zone (FAZ), foveal superficial capillary plexus (SCP) vessel density (VD), parafoveal SCP VD, foveal deep capillary plexus (DCP) VD, and parafoveal DCP VD with 95% confidence intervals (CIs) among migraine with aura (MA) group, migraine without aura (MO) group, and healthy controls (HC) group were analyzed using a random-effect model. P < 0.05 was considered significant in statistical analyses. Publication bias was assessed using funnel plots and statistical tests (Egger's test and Begg's test).ResultsNine studies covering 675 individuals were enrolled in this meta-analysis ultimately. The FAZ of MA patients was not significantly different from HC (WMD = 0.04, 95% CI −0.00 to 0.09). However, the FAZ of MA was significantly larger than that of HC after correction of publication bias by trim and fill method (WMD = 1.03, 95% CI 0.99 to 1.08). The FAZ of MO patients was similar to that of HC (WMD = 0.03, 95% CI −0.00 to 0.07), while smaller than that of MA patients (WMD = 0.05, 95% CI 0.01 to 0.09). VD of the SCP, either in the foveal or parafoveal area, was not significantly different among the three groups. As for DCP, VD in MA patients was lower when compared with HC in the parafovea (WMD = −1.20, 95% CI −1.88 to −0.51).ConclusionsWe found that there was a larger FAZ in MA compared with HC after adjusting for publication bias. The FAZ in MO was not significantly different from that in HC, but significantly lower than that in MA. There was no significant difference in either foveal or parafoveal VD of SCP among MA, MO, and HC participants, while the parafoveal VD of the DCP in MA was lower than that of the HC.

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Section: Introductionmentioning

confidence: 99%

Analysis of macular microvasculature with optical coherence tomography angiography for migraine: A systematic review and meta-analysis

Yu²,

Liu³

et al. 2022

Front. Neurol.

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“…CRAO and ION have been previously described in association with retinal migraine (2,5). The pathophysiology of CRAO and ION involves damage to blood vessels that supply either the retina or the optic nerve, and therefore theories that attempt to explain these complications include migraine-associated vasospasm of the retinal or ciliary vasculature, occlusive thrombosis as a result of endothelial dysfunction, abnormal platelet aggregability or plasma hypercoagulability (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

“…Retinal migraine is defined by The International Classification of Headache Disorders (ICHD) as an aura consisting of fully reversible monocular visual phenomena with at least two of the following characteristics: Spreading gradually over !5 min, symptoms lasting 5-60 min, accompanied, or followed within 60 min, by headache (1). The scientific literature reports a large spectrum of ocular complications from retinal migraine (2,3). Whereas the incidence of permanent loss of visual acuity or visual field from retinal migraine is not known, it may be underreported and underestimated (4).…”

Section: Introductionmentioning

confidence: 99%

Migrainous infarction of the eye: Two cases of monocular ischemic complications associated with retinal migraine

et al. 2021

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Background Retinal migraine is defined by fully reversible monocular visual phenomena. We present two cases that were complicated by permanent monocular vision deficits. Cases A 57-year-old man with history of retinal migraine experienced persistent monocular vision loss after one stereotypical retinal migraine, progressing to finger-count vision over 4 days. He developed paracentral acute middle maculopathy that progressed to central retinal artery occlusion. A 27-year-old man with history of retinal migraine presented with persistent right eye superotemporal scotoma after a retinal migraine. Relative afferent pupillary defect and superotemporal visual field defect were noted, consistent with ischemic optic neuropathy. Conclusion Retinal migraine can complicate with permanent monocular visual loss, suggesting potential migrainous infarction of the retina or optic nerve. A thorough cerebrovascular evaluation must be completed, which was unrevealing in our cases. Acute and preventive migraine therapy may be considered in retinal migraine patients, to mitigate rare but potentially permanent visual loss.

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“…Because an embolus can cause retinal artery occlusion, a systemic examination is particularly focused on the risk of mortal stroke and cardiovascular events. CRAO is reportedly associated with migraine, aura, obesity, hypertension, hypercholesterolemia, diabetes, and atrial fibrillation [ 5 , 40 , 41 , 42 ]. Young patients with CRAO significantly have several systemic factors, such as a hypercoagulable state, cardiac valvular disease, and migraine, reported to be associated with CRAO [ 43 , 44 ].…”

Section: Retinal Artery Occlusionmentioning

confidence: 99%

Risk Factors and Treatment Strategy for Retinal Vascular Occlusive Diseases

Terao

Fujino

Ahmed

2022

JCM

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Retinal occlusive diseases are common diseases that can lead to visual impairment. Retinal artery occlusion and retinal vein occlusion are included in the clinical entity, but they have quite different pathophysiologies. Retinal artery occlusion is an emergent eye disorder. Retinal artery occlusion is mainly caused by thromboembolism, which frequently occurs in conjunction with life-threatening stroke and cardiovascular diseases. Therefore, prompt examinations and interventions for systemic vascular diseases are often necessary for these patients. Retinal vein occlusion is characterized by retinal hemorrhage and ischemia, which may impair visual function via several complications such as macular edema, macular ischemia, vitreous hemorrhage, and neovascular glaucoma. Even though anti-vascular endothelial growth factor therapy is the current established first-line of treatment for retinal vein occlusion, several clinical studies have been performed to identify better treatment protocols and new therapeutic options. In this review, we summarize the current findings and advances in knowledge regarding retinal occlusive diseases, particularly focusing on recent studies, in order to provide an update for a better understanding of its pathogenesis.

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Risk of Retinal Artery Occlusion in Patients with Migraine

Cited by 16 publications

References 52 publications

Analysis of macular microvasculature with optical coherence tomography angiography for migraine: A systematic review and meta-analysis

Analysis of macular microvasculature with optical coherence tomography angiography for migraine: A systematic review and meta-analysis

Migrainous infarction of the eye: Two cases of monocular ischemic complications associated with retinal migraine

Risk Factors and Treatment Strategy for Retinal Vascular Occlusive Diseases

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