El-Shazly Amany Abd El-Fattah, Farweez Yousra Ahmed, Hamdi Momen Mahmoud, El-Sherbiny Noha Ezzat
a Department of Ophthalmology, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
Curr Eye Res. 2017 Sep;42(9):1327-1332. doi: 10.1080/02713683.2017.1319490. Epub 2017 Jun 21.
To study pattern visual evoked potential (PVEP), pattern electroretinogram (PERG), and retinal nerve fiber layer (RNFL) thickness in patients with migraine during and after aura.
We included 60 eyes of 60 patients with migraine (Group 1) and 30 healthy volunteers (30 eyes) as controls (Group 2). Group 1 was studied twice, during a visual aura (1-a) and in between attacks (1-b). All participants underwent full ophthalmological examination, PVEP, PERG, and optical coherence tomographyOCT imaging of the RNFL thickness for each patient.
RNFL thickness was found to be thinner in patients during the aura compared to controls. It increased significantly post-aura but remained lower than the controls. Prolonged P100 latency and decreased amplitude were found in patients during aura compared to controls with significant change in between attacks to values comparable to the controls. We found prolonged N95 latency and decreased amplitude in patients during aura compared to controls with significant change post-aura to values comparable to the controls. There was positive correlation between average RNFL thicknesses and VA and spherical equivalent; but it showed negative correlation with duration of migraine, attack duration, and aura duration. Multiple regression analysis showed that the most important determinants of average RNFL thickness in patients of migraine were attack and aura duration (beta = -0.21 and -0.26 and p = 0.03 and 0.04, respectively).
Migraine attacks impose both functional and structural retinal changes. The functional changes are fully reversible after the aura but not the structural ones. So, vigorous prevention of migraine attacks would be protective for retina.
研究偏头痛患者在先兆期及先兆期后发作时的图形视觉诱发电位（PVEP）、图形视网膜电图（PERG）以及视网膜神经纤维层（RNFL）厚度。
我们纳入了60例偏头痛患者的60只眼（第1组）以及30名健康志愿者的30只眼作为对照（第2组）。第1组在视觉先兆期（1 - a）和发作间期（1 - b）进行了两次研究。所有参与者均接受了全面的眼科检查、PVEP、PERG以及每位患者RNFL厚度的光学相干断层扫描（OCT）成像。
与对照组相比，偏头痛患者在先兆期的RNFL厚度更薄。先兆期后其显著增加，但仍低于对照组。与对照组相比，偏头痛患者在先兆期P100潜伏期延长且波幅降低，发作间期有显著变化，数值与对照组相当。与对照组相比，偏头痛患者在先兆期N95潜伏期延长且波幅降低，先兆期后有显著变化，数值与对照组相当。平均RNFL厚度与视力及球镜等效度呈正相关；但与偏头痛病程、发作持续时间及先兆持续时间呈负相关。多元回归分析表明，偏头痛患者平均RNFL厚度的最重要决定因素是发作及先兆持续时间（β分别为 - 0.21和 - 0.26，p分别为0.03和0.04）。
偏头痛发作会导致视网膜发生功能性和结构性改变。功能性改变在先兆期后可完全恢复，但结构性改变不能。因此，积极预防偏头痛发作对视网膜具有保护作用。
