Gramer Gwendolyn, Weber Bernhard H F, Gramer Eugen
Centre for Paediatric and Adolescent Medicine Division for Neuropaediatrics and Metabolic Medicine, University of Heidelberg, Heidelberg, Germany.
Institute of Human Genetics, University of Regensburg, Regensburg, Germany.
Invest Ophthalmol Vis Sci. 2015 Dec;56(13):7999-8007. doi: 10.1167/iovs.15-17274.
To evaluate frequency of migraine, vasospasm (VS), family history (FH) of migraine, and family history of glaucoma (FHG) in different types of glaucoma in relation to age and stage of visual field loss (VFL) at diagnosis.
A total of 2170 patients with glaucoma or ocular hypertension (OH) were interviewed by using standardized questions concerning FHG, age at diagnosis, and potential risk factors, including migraine and VS. Of 2027 patients providing information on migraine, 1244 had primary open-angle glaucoma (POAG), 140 normal tension glaucoma (NTG), 49 pigmentary glaucoma, 64 pseudoexfoliation glaucoma (PEX), 138 OH, and 218 primary angle closure glaucoma (PACG).
Of all patients, 13.7% reported migraine, 19.0% VS, 30.8% FH of migraine, and 40.3% FHG. Patients with FHG had a significantly higher frequency of migraine than patients without FHG (15.7% vs. 12.3%, P = 0.02). Migraine was significantly more frequent in NTG (21.4%) than POAG (13.1%; P = 0.01), PEX (7.8%; P = 0.02), and PACG (10.1%; P = 0.004). Compared to patients with POAG, patients with NTG had a 63.5% higher age-corrected probability for migraine (P = 0.007). There was no evidence for migraine or VS being prognostic factors regarding the extent of VFL at diagnosis. Migraine and VS were significantly more frequent in females.
The higher frequency of migraine and VS in females could contribute to the female preponderance in NTG. Our findings suggest an association of NTG and migraine and a common, possibly polygenetic, vascular etiology of these two diseases both with familial predisposition.
评估不同类型青光眼患者偏头痛、血管痉挛（VS）、偏头痛家族史（FH）以及青光眼家族史（FHG）的发生频率，并分析其与诊断时年龄及视野缺损（VFL）阶段的关系。
采用标准化问题对总共2170例青光眼或高眼压症（OH）患者进行访谈，内容涉及FHG、诊断时年龄以及包括偏头痛和VS在内的潜在危险因素。在2027例提供偏头痛相关信息的患者中，1244例患有原发性开角型青光眼（POAG），140例为正常眼压性青光眼（NTG），49例为色素性青光眼，64例为假性剥脱性青光眼（PEX），138例为高眼压症，218例为原发性闭角型青光眼（PACG）。
在所有患者中，13.7%报告有偏头痛，19.0%有VS，30.8%有偏头痛家族史，40.3%有青光眼家族史。有青光眼家族史的患者偏头痛发生频率显著高于无青光眼家族史的患者（15.7%对12.3%，P = 0.02）。正常眼压性青光眼患者偏头痛的发生频率（21.4%）显著高于原发性开角型青光眼患者（13.1%；P = 0.01）、假性剥脱性青光眼患者（7.8%；P = 0.02）和原发性闭角型青光眼患者（10.1%；P = 0.004）。与原发性开角型青光眼患者相比，正常眼压性青光眼患者经年龄校正后的偏头痛发生概率高63.5%（P = 0.007）。没有证据表明偏头痛或VS是诊断时视野缺损程度的预后因素。偏头痛和VS在女性中更为常见。
女性偏头痛和VS的较高发生率可能是正常眼压性青光眼女性占优势的原因。我们的研究结果表明正常眼压性青光眼与偏头痛之间存在关联，并且这两种疾病具有共同的、可能是多基因的血管病因，且均有家族易感性。
