Decreased visual field sensitivity measured 1 day, then 1 week, after migraine

To determine whether perimetric performance is worse the day after a migraine than prior interictal measurements, and if so, to determine whether differences have resolved by 1 week after migraine.

Twenty-two nonheadache control subjects (aged 18-45 years) and 22 migraineurs (aged 18-45 years: 10 migraine with visual aura, 12 migraine without aura) participated. Standard automated perimetry (SAP) and temporal modulation perimetry (TMP) were measured by perimeter (model M-700; Medmont, Pty Ltd., Camberwell, Victoria, Australia). Control subjects attended two test visits: baseline and retest. Migraineurs attended three times: baseline (>or=4 days after migraine), the day after the offset of the next migraine, and 7 days later. Groups were compared using the global indices of the perimeter: Average Defect (AD) and Pattern Defect (PD), in addition to point-wise comparisons.

Group migraineur TMP performance was significantly worse the day after a migraine, showing decreased general sensitivity and increased localized loss. Performance measured 7 days later was not significantly different from that measured the day after a migraine. Group migraineur SAP performance was not significantly worse after migraine; however, a subgroup of six eyes from five patients had 10 or more visual field locations with decreases in sensitivity greater than control test-retest 95% confidence limits.

Decreased visual field performance was present after migraine, as well as greater test-retest variability in the migraine group compared with control subjects. As migraineurs constitute 10% to 15% of the general population, the presence of this subgroup of patients with periodic prolonged decreased visual field sensitivity after migraine has implications for differential clinical diagnosis, and for clinical research using perimetry.