Evaluation of retinal vessel density and choriocapillaris flow in migraine patients with and without aura
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NEUROPHTHALMOLOGY
Evaluation of retinal vessel density and choriocapillaris flow in migraine patients with and without aura Pınar Bingöl Kızıltunç 1 & Gökçen Özcan 1 & Ferhad Özer 1 & Canan Togay Işıkay 2 & Huban Atilla 1 Received: 6 April 2020 / Revised: 4 June 2020 / Accepted: 15 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Migraine is thought to be a neurovascular disorder and increases the likelyhood to develop ischemic complications. Studies have shown that vascular disorders such as ischemic optic neuropathy, retinal artery and vein obstructions are more common in patients with migraine. This study aimed to evaluate the differences between retinal and optic disc microvasculature between migraine patients with and without aura and healthy controls using optical coherence tomography angiography (OCTA) imaging. Methods Thirty-three patients with migraine and 28 healthy subjects were included in this prospective cross sectional study. Optical coherence tomography angiography imaging was performed for the macula and optic disc. Vessel densities (VD) and choriocapillaris flow values were compared between three groups: control group, migraine with aura (MWA), and migraine without aura (MWOA). Results There was no difference between the three groups for the VDs of the foveal, perifoveal, parafoveal, and the whole area. The choriocapillaris flow of patients with MWA was significantly less than that of the MWOA and control groups. The VDs of the optic disc revealed no significant difference between the three groups. Conclusion A lack of choriocapillaris autoregulatory mechanisms may be a possible cause of the decrease in choriocapillaris flow in patients with MWA. Keywords Choriocapillaris . Migraine . Optical coherence tomography angiography . Vessel density
Introduction Migraine is one of the main causes of headache worldwide, and it is considered a neurovascular disorder. Although the pathophysiology of migraine is not fully understood, two main theories are proposed: the trigemino-vascular model and cortical spreading depression (CSD) [1, 2]. In these two theories, cerebral hypo-perfusion develops. Therefore, migraine is more likely to cause the development of ischemic complications. Owing to these vascular disorders in migraine, a decrease in perfusion in the optic nerve head and retina can be observed. A few case reports with ocular vascular disorders * Pınar Bingöl Kızıltunç [email protected] 1
Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey
2
Department of Neurology, Ankara University School of Medicine, Ankara, Turkey
such as ischemic optic neuropathy, retinal artery, and vein obstructions have been reported [3–5]. There are limited studies evaluating ocular vascular changes in migraine patients. In these studies, fundus photography and fundus video were used to evaluate the vascular changes [6, 7]. Optical coherence tomography angiography (OCTA) is an imaging method that provides detailed information about retinal microv
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