Department of Ophthalmology, University of Pécs Medical School, Rákóczi U. 2, Pécs, 7623, Hungary.
Department of Neurology, University of Pécs Medical School, Pécs, Hungary.
Sci Rep. 2024 Aug 30;14(1):20243. doi: 10.1038/s41598-024-71388-1.
To investigate neurovascular changes; including macular vascular density (VD), thickness of the ganglion cell layer (GCL) and optic nerve head (ONH) parameters in episodic migraine patients. 80 eyes of 40 episodic migraine patients were recruited. Thirty patients having a dominant side of migraine headache were statistically analyzed (5 male and 25 female; mean age 31.67 ± 9.54 years) and compared to 25 eyes of 25 healthy volunteers (5 male and 20 female; mean age of 34.4 ± 12.11 years, p = 0.361). The posterior segment was imaged with Topcon DRI optical coherence tomography (OCT) (Triton Swept source OCT Topcon, Japan), and OCT angiography (OCTA). Comparing the dominant side of migraine patients to controls we found a significant decrease of the VD in the central zone of the superficial and deep capillary plexus (SCP, p = 0.01; DCP, p = 0.004) and an enlarged foveal avascular zone (FAZ, p = 0.054). The GCL thickness was significantly reduced in the central ring (GCL + p = 0.042, GCL + + p = 0.029), as well as the retinal nerve fiber layer (RNFL) thickness in the temporal quadrant (p = 0.021) and border tissue of Elschnig diameter (BTE, p = 0.035). The duration of migraine showed an inverse correlation with SCP in the nasal quadrant (p = 0.016, r = - 0.445) and with all DCP regions [DCP superior (p = 0.004, r = - 0.519), DCP inferior (p = 0.004, r = - 0.519), DCP nasal (p = 0.006, r = - 0.496), DCP temporal (p = 0.005, r = - 0.508), DCP CSF (p < 0.001, r = - 0.634)]. The dominant side compared to the non-dominant side showed a significant deterioration of the VD in the inferior (p = 0.04) and temporal quadrants (p = 0.023); furthermore, a significant decrease in the GCL + + inner ring thickness (p = 0.046). Microvascular damage and consequent structural alterations of the retina and optic nerve head occur in the eyes of episodic migraine patient in association with the lateralization of the headache.
探讨偏头痛发作期患者的神经血管变化，包括黄斑血管密度（VD）、神经节细胞层（GCL）和视盘参数。
招募 40 例偏头痛发作期患者的 80 只眼，对偏头痛头痛优势侧的 30 例患者（5 例男性，25 例女性；平均年龄 31.67±9.54 岁）进行统计学分析，并与 25 例健康志愿者的 25 只眼（5 例男性，20 例女性；平均年龄 34.4±12.11 岁，p=0.361）进行比较。采用 Topcon DRI 光学相干断层扫描（OCT）（Triton 扫频源 OCT Topcon，日本）和 OCT 血管造影（OCTA）对后节进行成像。与对照组相比，偏头痛患者的优势侧发现浅层和深层毛细血管丛中央区的 VD 显著降低（SCP，p=0.01；DCP，p=0.004），且黄斑中心凹无血管区（FAZ）增大（p=0.054）。中央环的 GCL 厚度（GCL+p=0.042，GCL+ + p=0.029）以及颞象限的视网膜神经纤维层（RNFL）厚度（p=0.021）和 Elschnig 直径的边缘组织（BTE，p=0.035）显著降低。偏头痛发作持续时间与鼻象限的 SCP 呈负相关（p=0.016，r=-0.445），与所有 DCP 区域也呈负相关[DCP 上方（p=0.004，r=-0.519）、DCP 下方（p=0.004，r=-0.519）、DCP 鼻侧（p=0.006，r=-0.496）、DCP 颞侧（p=0.005，r=-0.508）、DCP 脑脊液（p<0.001，r=-0.634）]。与非优势侧相比，优势侧的 VD 在下方（p=0.04）和颞侧象限（p=0.023）显著恶化；此外，GCL+ + 内环厚度显著降低（p=0.046）。偏头痛发作期患者的眼部出现微血管损伤和视网膜及视盘结构改变，与头痛的偏侧化有关。
