Department of Optometry and Vision Sciences, The University of Melbourne, Australia.
Cephalalgia. 2014 Jan;34(1):42-57. doi: 10.1177/0333102413498939. Epub 2013 Aug 22.
In between migraine attacks, some people show visual field defects that are worse when measured closer to the end of a migraine event. In this cohort study, we consider whether electrophysiological responses correlate with visual field performance at different times post-migraine, and explore evidence for cortical versus retinal origin.
Twenty-six non-headache controls and 17 people with migraine performed three types of perimetry (static, flicker and blue-on-yellow) to assess different aspects of visual function at two visits conducted at different durations post-migraine. On the same days, the pattern electroretinogram (PERG) and visual evoked response (PVER) were recorded.
Migraine participants showed persistent, interictal, localised visual field loss, with greater deficits at the visit nearer to migraine offset. Spatial patterns of visual field defect consistent with retinal and cortical dysfunction were identified. The PERG was normal, whereas the PVER abnormality found did not change with time post-migraine and did not correlate with abnormal visual field performance.
Dysfunction on clinical tests of vision is common in between migraine attacks; however, the nature of the defect varies between individuals and can change with time. People with migraine show markers of both retinal and/or cortical dysfunction. Abnormal visual field sensitivity does not predict abnormality on electrophysiological testing.
在偏头痛发作之间，有些人会出现视野缺陷，而在偏头痛发作接近尾声时，这些缺陷会更严重。在这项队列研究中，我们考虑电生理反应是否与偏头痛后不同时间的视野表现相关，并探讨皮质与视网膜起源的证据。
26 名非头痛对照者和 17 名偏头痛患者在偏头痛发作后不同时间进行了三次视野检查（静态、闪烁和蓝黄），以评估不同方面的视觉功能，共进行了两次检查。在同一天，记录了图形视网膜电图（PERG）和视觉诱发电位（PVER）。
偏头痛患者表现出持续的、发作间期的、局部的视野丧失，在更接近偏头痛结束的检查中，视野缺损更大。确定了与视网膜和皮质功能障碍一致的视野缺陷的空间模式。PERG 正常，但发现的 PVER 异常并不随偏头痛后时间而变化，也与异常视野表现无关。
在偏头痛发作之间，视觉功能的临床测试常出现功能障碍；然而，缺陷的性质在个体之间有所不同，并且可能随时间而变化。偏头痛患者表现出视网膜和/或皮质功能障碍的标志物。异常的视野敏感性不能预测电生理测试的异常。
