Microvascular involvement in migraine: an optical coherence tomography angiography study

Area of Science:

• Ophthalmology
• Neurology
• Medical Imaging

Background:

• Migraine, a common neurological disorder, affects millions worldwide.
• Migraine with aura (MA) and migraine without aura (MO) are distinct subtypes.
• Microvascular changes in the retina may be associated with migraine pathophysiology.

Purpose of the Study:

• To evaluate macular and optic nerve microvasculature in MA and MO patients versus healthy controls (HC).
• To utilize optical coherence tomography angiography (OCTA) for detailed microcirculatory assessment.
• To identify potential OCTA biomarkers for migraine-related vascular changes.

Main Methods:

• Ocular examinations including motility, IOP, BCVA, refraction, and funduscopy.
• Macular and optic disc OCTA imaging using Solix full-range OCT.
• Analysis of OCTA parameters: vessel density (VD), retinal thickness, and foveal avascular zone (FAZ) area.
• Clinical and demographic data collection by a neurologist.

Main Results:

• The foveal avascular zone (FAZ) area was significantly larger in MA patients (0.248 mm²) compared to HC (0.184 mm²).
• Foveal choriocapillaris vessel density was significantly lower in MA patients (63.6%) versus MO patients (65.27%).
• No significant differences were noted in most other OCTA parameters between groups.

Conclusions:

• Retinal microcirculation impairment, evidenced by enlarged FAZ, is detectable in MA patients.
• Choroidal circulation studies may reveal microvascular damage in MA.
• OCTA serves as a valuable non-invasive tool for detecting microcirculatory disturbances in migraine patients.