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Comparison of ocular posterior segment parameters in the pediatric population with migraine without aura and
Ulviye Kıvrak1, Mehmet Tolga Köle2, İbrahim Kandemir3
1Department of Ophthalmology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye.
Insights
Children with migraine without aura (MWA) and tension-type headache (TTH) showed subtle posterior ocular structure differences. While not statistically significant, MWA patients had lower retinal nerve fiber layer thickness and macular thickness, warranting further investigation.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Migraine without aura (MWA) and tension-type headache (TTH) are common in children.
- Ocular symptoms can be present in both headache types.
- Posterior ocular structure parameters may differ between these conditions.
Purpose of the Study:
- To compare posterior ocular structure parameters in children with MWA, TTH, and healthy controls.
- To investigate potential differences in retinal nerve fiber layer thickness, macular thickness, choroidal thickness, and vascularity.
Main Methods:
- Study included 31 MWA patients, 29 TTH patients, and 38 healthy controls (ages 6-18).
- Optical coherence tomography (OCT) and OCT-angiography (OCTA) were used for measurements.
- Parameters measured: peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vessel densities, and foveal avascular zone (FAZ).
Main Results:
- No statistically significant differences in pRNFL thickness, CMT, or SCT between MWA, TTH, and control groups.
- Macular vascular densities were lower in MWA patients, with a significant difference in the nasal quadrant of the deep retinal capillary plexus.
- No significant differences in superficial or deep FAZ area parameters were found.
Conclusions:
- Differential diagnosis between MWA and TTH in children can be challenging due to overlapping ocular symptoms and posterior segment parameter changes.
- Long-term studies with larger cohorts and OCT-A are recommended to understand retinal changes in MWA and TTH.
Background:
This study aims to compare the posterior ocular structure parameters in children with migraine without aura (MWA), tension-type headache (TTH), and a healthy control group.
Methods:
The study included 31 patients with MWA, 29 patients with TTH, and 38 healthy controls between 6 and 18 years of age. For all participants, the detailed eye examination and measurements including peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vessel densities and foveal avascular zone (FAZ) parameters measured by optical coherence tomography (OCT) and OCT-angiography (OCTA), were obtained from the patient files.
Results:
The mean age was 12.1±3.3 years in MWA patients, 12.4±2.8 years in TTH patients, and 11.9±3.8 years in the healthy controls (p=0.844). Among the groups, the mean pRNFL thickness, CMT, and SCT values were lowest in the MWA group. However, this difference was not statistically significant (p=0.621, p=0.854 and p=0.201, respectively). The mean and four-quadrant (superior, inferior, temporal, nasal) pRNFL thicknesses, the CMT, and the SCT were not statistically significant between the groups (p=0.621, p=0.500, p=0.186, p=0.565, p=0.744, p=0.854 and p=0.201, respectively). The macular vascular densities were lower in MWA patients than in the other two groups, and there was a statistically significant difference between the groups only in the nasal quadrant of the deep retinal capillary plexus (p = 0.014). There were also no statistically significant differences between the groups in the superficial and deep FAZ area parameters (p=0.652 and p=0.985).
Conclusion:
This study suggested that differential diagnosis between MWA and TTH can be difficult in childhood, as these conditions, which can present with ocular symptoms, may also be characterized by changes in posterior segment parameters. Long-term studies incorporating OCT-A in larger patient populations may provide valuable insights into retinal changes associated with these two distinct headache spectrums.
