Romozzi Marina, Trigila Vincenzo, Cuffaro Giovanni, Marcelli Sofia, Iannone Luigi Francesco, Calabresi Paolo, Savino Gustavo, Vollono Catello
Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.
Neurologia, Dipartimento di neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Eur J Neurol. 2025 Jan;32(1):e16568. doi: 10.1111/ene.16568. Epub 2024 Nov 25.
This study aimed to analyze the microcirculation of the macula, the optic nerve, and the choroid in patients with migraine by optical coherence tomography angiography (OCTA) during spontaneous migraine attacks, comparing the findings with scans performed in the interictal period in the same subjects and healthy controls (HCs).
In this case-crossover design study, patients diagnosed with migraine who underwent an OCTA during a migraine attack were enrolled. A cohort of HCs was recruited for comparison. Data from ocular and orthotic examinations and clinical and demographical information were collected. All subjects were imaged with Solix full range OCT, recording the following parameters: macular vessel density (VD), inside disc VD, peripapillary VD, disc whole image VD, fovea choriocapillaris VD, fovea VD, parafovea VD, peripapillary thickness, fovea thickness, parafovea thickness, macular full retinal thickness, and foveal avascular zone (FAZ).
Thirteen patients (26 eyes individually assessed) with a diagnosis of migraine were included (9 without aura [69.2%] and 4 with aura [30.7%], with a mean age of 25.2 ± 3.4 years) and scanned during the ictal and interictal phase. Fifteen age-matched HCs (30 eyes individually assessed) were included. The foveal choriocapillaris VD was significantly lower in the ictal phase (63.3 ± 2.47%) compared to the interictal phase in the same patients (64.9 ± 2.79%) (p = 0.0019). Comparing the ictal scans from migraine patients and HCs, the FAZ area was significantly larger, and the inside disc, fovea, and fovea choriocapillaris VDs were significantly lower.
The study demonstrated a dynamic decrement in choroidal vascularization in migraine patients during spontaneous migraine attacks.
本研究旨在通过光学相干断层扫描血管造影（OCTA）分析偏头痛患者在自发偏头痛发作期间黄斑、视神经和脉络膜的微循环，并将结果与同一受试者发作间期扫描结果及健康对照（HCs）进行比较。
在这项病例交叉设计研究中，纳入了在偏头痛发作期间接受OCTA检查的偏头痛患者。招募了一组HCs作为对照。收集眼部和矫正检查数据以及临床和人口统计学信息。所有受试者均使用Solix全范围OCT成像，记录以下参数：黄斑血管密度（VD）、视盘内VD、视乳头周围VD、视盘全图像VD、中心凹脉络膜毛细血管VD、中心凹VD、旁中心凹VD、视乳头周围厚度、中心凹厚度、旁中心凹厚度、黄斑全视网膜厚度和中心凹无血管区（FAZ）。
纳入13例诊断为偏头痛的患者（单独评估26只眼）（9例无先兆[69.2%]，4例有先兆[30.7%]，平均年龄25.2±3.4岁），并在发作期和发作间期进行扫描。纳入15名年龄匹配的HCs（单独评估30只眼）。同一患者发作期中心凹脉络膜毛细血管VD（63.3±2.47%）显著低于发作间期（64.9±2.79%）（p = 0.0019）。比较偏头痛患者发作期扫描结果与HCs，FAZ面积显著更大，视盘内、中心凹和中心凹脉络膜毛细血管VD显著更低。
该研究表明偏头痛患者在自发偏头痛发作期间脉络膜血管化存在动态下降。
