Retinal nerve fiber layer measurements in patients with migraine with aura

Purpose: To evaluate the possible alterations of the retinal nerve fiber layer (RNFL), as detected by scanning laser polarimetry (SLP), that may occur in patients with migraine with aura. Methods: Twenty patients with migraine with aura and twenty normal subjects were studied. Inclusion criteria for the two groups included age of at least 18 years, no history of any ocular disease except refractive error or strabismus, and no family history of ocular hypertension or glaucoma. Potential subjects underwent a comprehensive eye examination. Exclusion criteria included refractive error greater than 5 DS and/or 2 DC, best-corrected visual acuity less than 20/40, intraocular pressure greater than 21 mmHg, abnormal optic discs, cup-todisc ratio (C/D) greater than 0.5 or asymmetry between C/D of the two eyes greater than 0.2, or any other concomitant retinal pathology. The patients were submitted to a Humphrey Field (30-2) examination and RNFL analysis using the GDx Nerve Fiber Analyzer. One eye from each patient was randomly selected for statistical analysis. Results: None of our controls had any visual field defects. Nine eyes (45%) from migraine patients had visual-field abnormalities beyond 95% normal confidence limits, as indicated by MD, CPSD or GHT. The retardation values of the superior nerve fiber layer of migraine patients were significantly lower than values in normal patients (p=0.005). No significant differences were observed in global, inferior, temporal and nasal measurements between the two groups. Conclusions: In this study, the RNFL measurements were significantly lower in the superior retina of migraine patients, indicating that these patients might have migraine-related ischemic damage of nerve fibers.

Duke Scholars

Author Felipe Medeiros Ophthalmology, Glaucoma