1 Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
2 Department of Opthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Cephalalgia. 2018 Apr;38(4):736-743. doi: 10.1177/0333102417708774. Epub 2017 May 10.
Background To explore the role of microvascular pathology in migraine, we investigated the association between migraine and retinal microvascular damage. Methods We included 3270 participants (age ≥ 45 years, 63% women) from the population-based Rotterdam Study (2006-2009). Participants with migraine were identified using a validated questionnaire based on ICHD-II criteria (n = 562). Retinopathy signs were graded on fundus photographs. Retinal arteriolar and venular caliber were measured by semi-automatic assessment of fundus photographs. Associations of migraine with retinopathy and retinal microvascular calibers were examined using logistic and linear regression models, respectively, adjusting for age, sex, and cardiovascular risk factors. Results Migraine was not associated with the presence of retinopathy (odds ratio (OR): 1.09, 95% confidence interval (CI) 0.62; 1.92). In the fully adjusted model, adjusting for the companion vessel, persons with migraine did not differ in retinal arteriolar or venular caliber compared to persons without migraine (mean difference in standardized arteriolar caliber -0.05 (95%CI -0.13; 0.03); in standardized venular caliber -0.00 (95%CI -0.09; 0.08)). Migraine subtypes, including migraine with aura, were also not associated with retinal microvascular damage. Conclusions Our findings suggest that migraine is not associated with retinopathy or difference in retinal microvascular caliber. Further studies are needed to confirm these results.
为了探索微血管病变在偏头痛中的作用,我们研究了偏头痛与视网膜微血管损伤之间的关系。
我们纳入了来自基于人群的鹿特丹研究中的 3270 名参与者(年龄≥45 岁,63%为女性)(2006-2009 年)。使用基于 ICHD-II 标准的经过验证的问卷来识别偏头痛患者(n=562)。在眼底照片上分级视网膜病变征象。通过眼底照片的半自动评估来测量视网膜小动脉和小静脉的口径。使用逻辑回归和线性回归模型分别检查偏头痛与视网膜病变和视网膜微血管口径的相关性,调整年龄、性别和心血管危险因素。
偏头痛与视网膜病变的发生无关(比值比(OR):1.09,95%置信区间(CI):0.62;1.92)。在完全调整模型中,在校正伴行血管后,偏头痛患者的视网膜小动脉或小静脉口径与无偏头痛患者没有差异(标准化小动脉口径的平均差异-0.05(95%CI:-0.13;0.03);标准化小静脉口径的平均差异-0.00(95%CI:-0.09;0.08))。偏头痛亚型,包括有先兆偏头痛,也与视网膜微血管损伤无关。
我们的研究结果表明,偏头痛与视网膜病变或视网膜微血管口径差异无关。需要进一步的研究来证实这些结果。