Optical coherence tomography is a useful tool for monitoring treatment response in migraine: a prospective...

Migraine is a primary headache disorder wherein vascular changes are well known. We aimed to evaluate the retinal and choroidal parameters in migraine patients longitudinally, with a particular focus on treatment-related changes.

We conducted a prospective longitudinal study of 45 patients with migraine (ICHD-3 criteria) who were indicated for prophylactic treatment. The patients were evaluated clinically using the visual analogue scale (VAS), monthly migraine days (MMD), migraine disability assessment score (MIDAS), and Optical Coherence Tomography (OCT) at baseline and after 3 months of follow-up. The peripapillary retinal nerve fibre layer (PPRNFL), peripapillary choroid thickness (PPCHT), subfoveal choroid thickness (SFC), ganglion cell layer (GCL), and central macular thickness (CMT) were the parameters assessed using OCT. 45 age- and gender-matched healthy controls were recruited for comparison of baseline parameters.

The majority of patients (38/45) were females, and the mean age was 37.3 ± 10.0 years. The PPRNFL, PPCHT, SFC LE, GCL, and CMT were thinner in patients than in controls. All parameters, except the GCL and CMT, increased significantly during follow-up after 3 months of prophylactic treatment.

This longitudinal study demonstrated partial structural recovery, suggesting that some retinal and choroidal changes in migraine may be reversible. Our findings support the role of these OCT parameters as surrogate markers of disease burden and treatment response in migraine. Large-scale, multicentre prospective studies with longer follow-up are warranted to evaluate the prognostic utility of OCT parameters in migraine.