Güler Özlem, Güler Mete, Tuğan Yıldız Cemile Buket, Hakkoymaz Hakan
School of Medicine, Department of Emergency Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
Neuroophthalmology. 2020 Jun 12;44(5):299-306. doi: 10.1080/01658107.2020.1752260. eCollection 2020.
Migraine pathophysiology is complex and partially includes the vasculature. This study compared retinal and peripapillary blood flow parameters in migraine patients during an attack with healthy controls using optical coherence tomography angiography (OCTA). A prospective clinical study was conducted including 52 eyes from 26 migraineurs and 48 eyes from 24 healthy controls. OCTAs were performed with RTVue XR Avanti using AngioVue software. OCTA imaging was performed during the attack period in migraineurs before any treatment for the attack. Vascular densities in the whole image, fovea, superior hemisphere, inferior hemisphere, and temporal, superior, nasal, and inferior regions of the parafoveal area and in the superficial and deep capillary plexuses were acquired and statistically analysed. The flow density parameters were measured in the superficial retinal capillary plexus, deep retinal capillary plexus, outer retinal capillary plexus, and choriocapillaris layers of the macula in a 3-mm diameter area. The peripapillary flow densities were measured for the optic nerve head, vitreous, radial peripapillary capillaries, and choroid in a 4.50-mm diameter area around the optic disc. Vascular density measurements in the superficial plexus were similar between migraineurs and controls ( > .05). Vascular densities in the deep capillary plexus were similar between groups ( > .05), except in the deep superior area ( = .05). Flow areas in the nerve head, vitreous, peripapillary capillary, and choroid segments were similar between migraineurs and controls ( > .05). Macular thickness parameters were also similar between groups ( > .05). The results suggest that an acute migraine attack does not affect retinal or peripapillary blood flow.
偏头痛的病理生理学很复杂，部分与脉管系统有关。本研究使用光学相干断层扫描血管造影（OCTA）比较了偏头痛发作期患者与健康对照者的视网膜和视乳头周围血流参数。进行了一项前瞻性临床研究，纳入了26例偏头痛患者的52只眼和24例健康对照者的48只眼。使用AngioVue软件通过RTVue XR Avanti进行OCTA检查。在偏头痛患者发作期且未进行任何发作治疗前进行OCTA成像。获取并统计分析全图像、中央凹、上半侧、下半侧以及黄斑旁区域颞侧、上侧、鼻侧和下侧区域以及浅表和深层毛细血管丛中的血管密度。在黄斑区直径3 mm区域内测量浅表视网膜毛细血管丛、深层视网膜毛细血管丛、外层视网膜毛细血管丛和脉络膜毛细血管层的血流密度参数。在视盘周围直径4.50 mm区域内测量视神经乳头、玻璃体、视乳头周围放射状毛细血管和脉络膜的视乳头周围血流密度。偏头痛患者和对照组浅表丛中的血管密度测量值相似（P>0.05）。除深上区域外（P = 0.05），两组间深层毛细血管丛中的血管密度相似（P>0.05）。偏头痛患者和对照组在神经乳头、玻璃体、视乳头周围毛细血管和脉络膜段的血流面积相似（P>0.05）。两组间黄斑厚度参数也相似（P>0.05）。结果表明，急性偏头痛发作不会影响视网膜或视乳头周围血流。
