与屈光不正相关的头痛：特征和危险因素。

Headache associated with refractive errors: Characteristics and risk factors.

机构信息

Internal Security Forces Hospital, rue Mohamed Fadhel Ben Achour, 2078, Marsa Safsaf, Tunis, Tunisie.

出版信息

Rev Neurol (Paris). 2021 Oct;177(8):947-954. doi: 10.1016/j.neurol.2020.10.008. Epub 2021 Jan 20.

DOI:10.1016/j.neurol.2020.10.008

PMID:33483090

Abstract

INTRODUCTION

The purpose of our work was to study the characteristics of Headache associated with refractive errors (HARE), and to search for the correlation between headaches characteristics and some risk factors. We aimed also to assess the impact of these headaches on the quality of life of patients.

METHODS

A cross-sectional, retrospective, comparative study including 90 patients followed between August 2019 and January 2020. These patients were divided into two groups: Group 1 including patients presenting headaches due to uncorrected ametropia, and group 2 including control subjects. We studied HARE characteristics, the influence of certain risk factors (profession, triggers factors, characteristics of ametropia, and orthoptic abnormalities) on them, their evolution after one month of treatment, and their impact on patients' quality of life with the HIT-6 score.

RESULTS

Headaches due to ametropia were mainly chronic (20.9±15.76 months on average) progressive (100% of cases), daily (90% of cases) predominantly during the second half of the day (82% of cases). They were moderate (64% of cases), with a fronto-orbital topography in 52% of cases. Headaches were compression-type in 36% of cases (18 patients) and pressure-type in 64% (32 patients). The multivariate study retained prolonged screen working (P=0.013), combined ametropias (P=0.001), moderate hyperopia (P=0.01) and astigmatism (P=0.03) to be risk factors of HARE. Headaches induced a substantial to major impact on the quality of life in 68% (34 patients had a score greater than 55), the latter is significantly influenced by the presence of high myopia. After optical correction and orthoptic treatment, we noted an improvement in headache in 100% of cases. The multivariate analysis did not identify any independent factor that impact the evolution of headache at one month.

CONCLUSION

HARE may influence life quality; it needs an appropriate treatment based on risk factor management. A healthy lifestyle in addition to adequate refractive error correction is essential in children and, sometimes in adults. Oculomotor abnormalities treatment leads to improve long term results.

摘要

简介

我们工作的目的是研究与屈光不正相关的头痛（HARE）的特征，并寻找头痛特征与某些危险因素之间的相关性。我们还旨在评估这些头痛对患者生活质量的影响。

方法

一项横断面、回顾性、对照研究，纳入了 2019 年 8 月至 2020 年 1 月期间随访的 90 名患者。这些患者分为两组：第 1 组包括因未矫正屈光不正而出现头痛的患者，第 2 组包括对照组。我们研究了 HARE 的特征、某些危险因素（职业、触发因素、屈光不正特征和斜视异常）对其的影响、治疗一个月后的演变以及 HIT-6 评分对患者生活质量的影响。

结果

屈光不正引起的头痛主要是慢性（平均 20.9±15.76 个月）、进行性（100%的病例）、每日（90%的病例）头痛，主要发生在下午后半段（82%的病例）。头痛程度中等（64%的病例），眶额部疼痛占 52%（47 例）。头痛呈压迫型（36%的病例，18 例）和压力型（64%的病例，32 例）。多变量研究保留了长时间屏幕工作（P=0.013）、混合性屈光不正（P=0.001）、中度远视（P=0.01）和散光（P=0.03）作为 HARE 的危险因素。头痛对生活质量有显著的影响，68%（34 例患者得分大于 55），后者受高度近视的显著影响。经过光学矫正和斜视治疗后，我们注意到 100%的病例头痛均有改善。多变量分析未发现任何独立因素影响一个月时头痛的演变。