Short-Wavelength Sensitivity Deficits in Patients With Migraine

Abstract

To examine short-wavelength sensitivity in patients with migraine using short-wavelength automated perimetry (SWAP) and Stiles 2-color increment threshold procedures. Methods: Twenty-five subjects with migraine with (n=11) and without (n = 14) aura and 20 age-matched headache-free subjects underwent testing. All subjects underwent standard automated perimetry (SAP) and SWAP (using a Humphrey field analyzer; 24-2 presentation pattern). In 2 migraine patients (one with and another without aura), the 2-color increment threshold procedure was used to determine whether sensitivity losses were specific to short-wavelength sensitivity pathways or a generalized loss to multiple pathways. Results: No statistically significant differences between migraine patients and controls were found for mean deviation (MD) or pattern-standard deviation (PSD) for SAP. However, for SWAP, MD and PSD were worse for the migraine group (P = .04). Twelve migraine patients had more than 4 locations with sensitivity worse than the 5% probability level (reference value). Increment threshold determinations in the 2 selected migraine patients indicated a selectively greater loss for short-wavelength sensitivity mechanisms. Conclusions: Approximately 50% of subjects with migraine (with or without aura) demonstrate SWAP sensitivity losses, at times between migraine events. These findings, in conjunction with previous results for SAP and flicker perimetry, suggest that migraine patients should be excluded from normative databases of visual function, and warrant further investigations of the relationship between migraine and glaucoma.

The optometric correlates of migraine

“…Comoglu et al (2003) found glaucomatous-like visual field defects in patients with migraine in the absence of raised intraocular pressures and suggested that there might be a relationship between the pathophysiology of normal tension glaucoma and migraine. McKendrick agreed with this viewpoint (McKendrick et al, 2000(McKendrick et al, , 2002 and concluded that the similarity of SWAP defects and temporally modulated perimetry defects in migraine sufferers and glaucoma sufferers might raise the possibility of a common pre-cortical vascular involvement in these two conditions.…”

“…McKendrick et al (2002) performed short-wavelength automated perimetry (SWAP) and standard automated perimetry (SAP) using a Humphrey Visual Field Analyser. Although they did not find a significant difference in mean deviation and pattern standard deviation between migraine sufferers and controls using SAP, both these parameters were significantly worse in the migraine group using SWAP.…”

Assessment of spatial–contrast function and short-wavelength sensitivity deficits in patients with migraine

“…[1][2][3][4][5] This abnormal function does not seem to result from the direct effect of visual aura on cortical visual pathways, because deficits have been reported in subjects who do not experience visual aura as well as in those who do. [1][2][3][4][5][6][7][8] In addition to as well as homonymous defects, which shows cortical involvement, [12][13][14] unilateral nonhomonymous defects were also detected resembling a more localized defect. [1][2][3]5 There is substantial evidence that visual information is transmitted from the retina to cortical area V1 by three pathways that are largely separate, both anatomically and functionally.…”

“…[1][2][3][4][5][6][7][8] In addition to as well as homonymous defects, which shows cortical involvement, [12][13][14] unilateral nonhomonymous defects were also detected resembling a more localized defect. [1][2][3]5 There is substantial evidence that visual information is transmitted from the retina to cortical area V1 by three pathways that are largely separate, both anatomically and functionally. These are parvocellular (P), magnocellular (M), and koniocellular (K) pathways.…”

“…[1][2][3][4][5] This abnormal visual field function does not seem to result from visual aura as deficits have also been reported in patients who do not experience visual aura. [6][7][8] Although homonymous visual field deficits characteristic of cortical involvement have been reported after migraine, most are nonhomonymous and often are unilateral implying precortical involvement.…”