The Near Point of Convergence in Patients with Vestibular Migraine

Introduction  Vestibular migraine (VM) is one of the most common vestibular disorders and its diagnosis is based entirely on clinical features. A recent case series suggested a possible link between migraines and convergence insufficiency. Objective  To compare the near point of convergence (NPC) in patients with and without VM. Methods  We retrospectively reviewed the data of 50 patients with and 50 without VM, comparing the NPC between both groups. The NPC was measured according to the recommendations of the American Academy of Ophthalmology. Differences in the results between groups were compared using the Mann-Whitney test. The association of the NPC with age, gender, and the use of corrective glasses or contact lenses was evaluated by the Student t or Mann-Whitney tests for parametric and nonparametric data, respectively. To determine the diagnostic accuracy and optimal cut-off point, receiver operating characteristic (ROC) curves were created. Results  The mean NPC was significantly higher in patients with VM (18.50 ± 5.88 cm) compared to the control group (8.06 ± 1.46 cm; p  < 0.001). The area under the curve (AUC) was 0.986 (95% CI: 0.938-0.999; p  < 0.0001), suggesting that NPC was able to accurately discriminate between patients with and without VM with a sensitivity of 94% and specificity of 100%. Conclusion  Our results suggest that convergence insufficiency is a common sign in patients with VM and may be considered a potential clinical biomarker. However, further studies are needed to confirm this hypothesis.