Reggio Ester, Chisari Clara G, Ferrigno Giulia, Patti Francesco, Donzuso Giulia, Sciacca Giorgia, Avitabile Teresio, Faro Salvatore, Zappia Mario
Department "G.F. Ingrassia" Section of Neuroscience, Policlinico G. Rodolico, University of Catania, via Santa Sofia 78, 95123, Catania, Italy.
Department of Ophthalmology, Policlinico G. Rodolico, University of Catania, via Santa Sofia 78, 95123, Catania, Italy.
J Neurol. 2017 Mar;264(3):494-502. doi: 10.1007/s00415-016-8364-0. Epub 2016 Dec 27.
Few studies have evaluated whether the retina is involved in migraine through the evaluation of retinal nerve fiber layer (RNFL) examined with ocular coherence tomography (OCT) with conflicting results. Aim of this case-control study is to evaluate the retina and the choroid in migraine. Patients having migraine with aura (MwA) or without aura (MoA) and chronic migraine (CM) were evaluated. Age- and sex-matched normal subjects were selected as healthy controls (HC). Patients and HC were examined with OCT. RNFL, ganglion cell layer (GCL), foveal thickness (FT), choroidal thickness (CT) and total macular volume (TMV) were calculated for right eyes (RE) and left eyes (LE). Seventy-seven patients (62 women; 80.5%), 21 MoA, 12 MwA, 44 CM and 42 HC were enrolled in the study. Patients compared to HC had a significant reduction of RNFL (RE: 91.2 ± 9.2 vs 99.3 ± 7.5 μm; p < 0.001. LE: 93.3 ± 8.7 vs 100.2 ± 6.5 μm; p < 0.001). GCL (RE: 80.6 ± 6.4 vs 86.9 ± 2.1 μm; p < 0.0001. LE: 81.5 ± 5.7 vs 87.1 ± 2.6 μm; p < 0.0001) and CT (RE: 286.4 ± 31.4 vs 333.2 ± 3.1 μm; p < 0.0001. LE: 287.2 ± 31.6 vs 334.5 ± 4.1 μm; p < 0.0001) were thinner in patients compared to HC. Moreover, CM showed reduction of RNFL and of GCL compared to the other migraineurs. Finally, we found a significant inverse correlation between RNFL thickness and total number of headache attacks per months. Our data suggest the involvement of retina and choroid in migraineurs, especially in the CM group. Although migraine is an episodic and recurrent disease, its chronic nature might cause permanent structural abnormalities involving not only the brain, but also the retina.
很少有研究通过光学相干断层扫描（OCT）对视网膜神经纤维层（RNFL）进行评估，以判断视网膜是否参与偏头痛，而研究结果相互矛盾。本病例对照研究的目的是评估偏头痛患者的视网膜和脉络膜。对有先兆偏头痛（MwA）、无先兆偏头痛（MoA）和慢性偏头痛（CM）的患者进行了评估。选择年龄和性别匹配的正常受试者作为健康对照（HC）。对患者和健康对照进行了OCT检查。计算了右眼（RE）和左眼（LE）的RNFL、神经节细胞层（GCL）、黄斑中心凹厚度（FT）、脉络膜厚度（CT）和黄斑总体积（TMV）。77例患者（62名女性；80.5%）、21例MoA、12例MwA、44例CM和42名HC纳入研究。与健康对照相比，患者的RNFL显著降低（右眼：91.2±9.2 vs 99.3±7.5μm；p<0.001。左眼：93.3±8.7 vs 100.2±6.5μm；p<0.001）。与健康对照相比，患者的GCL（右眼：80.6±6.4 vs 86.9±2.1μm；p<0.0001。左眼：81.5±5.7 vs 87.1±2.6μm；p<0.0001）和CT（右眼：286.4±31.4 vs 333.2±3.1μm；p<0.0001。左眼：287.2±31.6 vs 334.5±4.1μm；p<0.0001）更薄。此外，与其他偏头痛患者相比，CM患者的RNFL和GCL有所降低。最后，我们发现RNFL厚度与每月头痛发作总数之间存在显著负相关。我们的数据表明视网膜和脉络膜参与了偏头痛患者，尤其是CM组。尽管偏头痛是一种发作性和复发性疾病，但其慢性性质可能会导致永久性结构异常，不仅累及大脑，还累及视网膜。
