Related Experiment Video
Updated: Nov 24, 2025
A Murine Model of Ischemic Retinal Injury Induced by Transient Bilateral Common Carotid Artery Occlusion
Published on: November 12, 2020
Risk of Retinal Artery Occlusion in Patients with Migraine
Ahmad Al-Moujahed1, Elaine M Tran1, Amee Azad1
1Department of Ophthalmology, Byers Eye Institute, Horngren Family Vitreoretinal Center, Stanford University School of Medicine, Palo Alto, California, USA.
Purpose:
We sought to determine if migraine is associated with increased risk of retinal artery occlusion (RAO).
Design:
Retrospective cohort study.
Methods:
We reviewed a large insurance claims database for patients with migraine and matched control subjects without migraine between 2007 and 2016. Cox proportional hazard regression models were used to investigate the association between migraine and risk of all RAO, central RAO (CRAO), branch RAO (BRAO), and "other" RAO, which includes transient and partial RAO. Primary outcome measures included the incidence of all RAO, including CRAO, BRAO, and other RAO, after first migraine diagnosis.
Result:
There were 418,965 patients with migraine who met the study criteria and were included in the analysis with the appropriate matched control subjects. Among the 418,965 patients with migraine, 1060 (0.25%) were subsequently diagnosed with RAO, whereas only 335 (0.08%) of the patients without migraine were diagnosed with RAO. The hazard ratio (HR) for incident all RAO in patients with migraine compared with those without migraine was 3.48 (95% confidence interval [CI] 3.07-3.94; P < .0001). This association was consistent across all types of RAO, including CRAO (HR 1.62 [95% CI 1.15-2.28]; P = .004), BRAO (HR 2.09 [95% CI 1.60-2.72]; P < .001), and other types of RAO (HR 4.61 [95% CI 3.94-5.38]; P < .001). Patients with migraine with aura had a higher risk for incident RAO compared with those with migraine without aura (HR 1.58 [95% CI 1.40-1.79]; P < .001). This association was consistent for BRAO (HR 1.43 [95% CI 1.04-1.97]; P < .03) and other types of RAO (HR 1.67 [95% CI 1.45-1.91]; P < .001) but was not statistically significant for CRAO (HR 1.18 [95% CI 0.75-1.87]; P = .475). Significant risk factors for this association included increased age, male sex, acute coronary syndrome, valvular disease, carotid disease, hyperlipidemia, hypertension, retinal vasculitis or inflammation, and systemic lupus erythematosus.
Conclusions:
Migraine is associated with increased risk of all types of RAO and migraine with aura is associated with increased risk of RAO compared with migraine without aura.
Insights
Migraine significantly increases the risk of retinal artery occlusion (RAO). Patients with migraine, especially with aura, face a higher likelihood of developing RAO, highlighting a critical link between these conditions.
Area of Science:
- Ophthalmology and Neurology
- Vascular Medicine
Background:
- Migraine is a common neurological disorder.
- Retinal artery occlusion (RAO) is a serious condition causing vision loss.
Purpose of the Study:
- To investigate the association between migraine and the risk of developing RAO.
- To determine if migraine increases the likelihood of various types of RAO, including central (CRAO) and branch (BRAO).
Main Methods:
- A retrospective cohort study utilizing a large insurance claims database from 2007-2016.
- Cox proportional hazard regression models were employed to analyze the risk of RAO in patients with and without a migraine diagnosis.
- The study analyzed the incidence of all RAO, CRAO, BRAO, and other RAO types post-migraine diagnosis.
Main Results:
- The study included 418,965 patients with migraine and matched controls.
- Patients with migraine had a 3.48-fold increased risk of all RAO compared to those without migraine (P < .0001).
- Migraine with aura was associated with a higher risk of RAO (HR 1.58) compared to migraine without aura.
Conclusions:
- Migraine is significantly associated with an increased risk of all types of RAO.
- Migraine with aura confers a greater risk of RAO compared to migraine without aura.
- The findings underscore the importance of considering vascular risks in migraine patients.
Related Concept Videos
01:26Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
01:25Glaucoma: Overview