Evaluation of retina nerve fiber and choroid layer thicknesses in patients with migraine by using optic coherens tomography

Objective: Our aim in this study is to examine retina, choroid and retina nerve fiber layer thickness by optical coherence tomography in migraine patients with or without attact. Method: The study presenting at Abant Izzet Baysal Univercity Hospital included 87 migraine patients without attact, 21 migraine patients with attact diagnosed by the Neurology Departmant with criteria of International Headache Society's guidelines 2004 and 85 healthy volunteers which selected from Opthalmology Departmant Outpatient Clinic. Right eye of the patients recorded to analysis. All patients were performed detailed opthalmological examination including best corrected visual acuity, intaocular pressure, central cornea thickness, biomicroscopic examination and fundus examination. All patients' retina, choroid and retina nerve fiber layer thickness' were performed by Spectralis® optical coherence tomography. Statistical analysis of the data was performed using the SPSS software and p<0.05 was considered statistically significant. Results: All the eyes in the study had a visual acuity of 10/10 with snellen scale and their anterior and posterior segment examination findings were normal. There was no statistically significant differance with age and sex parameters among the three groups (p>0.005). There was no statistically significant differance with migraine duration, attack frequency and visual analog scale between migraine patients with attact and without attact (p>0.005). Subfoveal retina and choroid thickness' are measured respectively 214.83 ± 13.76 μm, 339.34 ± 74.93 μm; 213.42 ± 15.4 μm, 355.23 ± 98.65 μm and 218.34 ± 18.79 μm, 338.98 ± 92.8 μm in migraine without attact, migraine with attact and control groups. There was no statistically significant differance with subfoveal retina and choroid thickness among the three groups (p>0.005). Retinal nerve fiber layer thickness in global and temporal-inferior segment were found significantly thinner in the migraine patients' without attact (respectively 100.78 ± 8.95 μm, 148.36 ± 20.16 μm) and migraine patient' with attact (respectively 98.33 ± 11.98 μm, 146.09 ± 22.67 μm) than the contol group ( respectively 103.35 ± 8.81 μm, 154.91 ± 16.94 μm) ( p value respectively 0.044 ve 0.039). There was no statistically significant differance with intaocular pressure and central cornea thickness among the three groups (p>0.005). All the migraine patients were seperated into two groups according to the presence of aura. Retinal nerve fiber layer thickness in nasal segment was found significantly thinner in the patients with aura (70.53 ± 13.48 μm) than the patients without aura (77.51 ± 14.19 μm) (p=0.007). There wasn't found any significant corelation among migraine duration and retina, choroid and retinal nerve fiber layer thickness. Conclusion: Retinal nerve fiber layer thickness in global and temporal inferior segments were found thinner in migraine patients with and without attact than the control group. Migraine disease can cause loss of retinal nerve fiber layer thickness and be a risk factor for the normal tension glaocoma. Therefore it can be usefull to follow the migraine patients opthalmologically. Key words: Migraine, optical coherence tomography, retinal nerve fiber layer, retina, choroid.