Harle Deacon E, Shepherd Alex J, Evans Bruce J W
The Neville Chappell Research Clinic, The Institute of Optometry, London, UK.
Headache. 2006 Oct;46(9):1431-40. doi: 10.1111/j.1526-4610.2006.00585.x.
To investigate the associations between interictal pattern glare, visual stress, and visual triggers of migraine.
There has been relatively little research on the visual stimuli that can trigger migraine episodes. This is surprising, since if practitioners can obviate such triggers, then some attacks may be prevented. The existing literature suggests that patients who are prone to visually triggered migraines report more illusions on viewing striped patterns ("pattern glare") and that colored filters may be an effective intervention for these people.
Headache symptoms and headache triggers were investigated in migraine and control groups in 2 separate experiments. In one experiment, we also determined, for each participant, pattern glare, whether it was reduced by colored filters and, if so, what the optimum color of filter was. Color vision was also assessed with the D15 test.
People with migraine saw significantly more illusions on viewing each striped pattern and experienced greater pattern glare. They were also more likely to select a colored filter to aid visual comfort, particularly colors in the blue-to-green sector of the spectrum. Color vision was impaired subtly but significantly in migraine. Principal component analyses grouped common headache triggers into 5 broadly equal components: food, visual triggers, alcohol, stress and tiredness, and the environment. In a second analysis, the overall number of illusions seen in striped patterns was associated with visual triggers while pattern glare, use of colored filters, and interictal light sensitivity together formed a sixth component interpreted as visual stress.
It is suggested that clinicians should ask migraine patients whether visual stimuli trigger their migraine, about interictal visual symptoms, and use the pattern glare test to ensure that those who may benefit from optometric interventions are appropriately managed.
研究发作间期模式眩光、视觉应激与偏头痛视觉触发因素之间的关联。
关于可触发偏头痛发作的视觉刺激的研究相对较少。这令人惊讶，因为如果医生能够消除此类触发因素，那么一些发作可能会被预防。现有文献表明，容易出现视觉触发型偏头痛的患者在观看条纹图案时（“图案眩光”）会报告更多幻觉，并且彩色滤光片可能对这些人是一种有效的干预措施。
在2个独立实验中对偏头痛组和对照组的头痛症状及头痛触发因素进行了调查。在一个实验中，我们还为每位参与者确定了图案眩光、彩色滤光片是否能减轻图案眩光，如果可以，最佳滤光片颜色是什么。还使用D15测试评估了色觉。
偏头痛患者在观看每种条纹图案时看到的幻觉明显更多，并且经历了更大的图案眩光。他们也更有可能选择彩色滤光片来提高视觉舒适度，特别是光谱中蓝到绿区域的颜色。偏头痛患者的色觉有轻微但显著的受损。主成分分析将常见的头痛触发因素分为5个大致相等的成分：食物、视觉触发因素、酒精、压力和疲劳以及环境。在第二项分析中，条纹图案中看到的幻觉总数与视觉触发因素相关，而图案眩光、彩色滤光片的使用以及发作间期光敏感性共同形成了第六个成分，被解释为视觉应激。
建议临床医生询问偏头痛患者视觉刺激是否会触发他们的偏头痛、发作间期视觉症状，并使用图案眩光测试，以确保那些可能从验光干预中受益的患者得到适当的管理。
