Visual Field Defects and Retinal Nerve Fiber Layer Thickness in Migraine Patients: A Study From a Tertiary Care Center in India

TL;DR

This study found that migraine patients experience visual field defects and retinal nerve fiber layer thinning during headache attacks.

Contribution

The study provides new evidence of RNFL thinning and localized visual field changes in Indian migraine patients during headache phases.

Findings

44% of migraine patients had generalized visual field defects during headache attacks.

Superior quadrant RNFL thickness was significantly thinner in migraine patients compared to controls (p < 0.001).

Abstract

Background

This study aimed to analyze the visual field changes and retinal nerve fiber layer (RNFL) thickness during the headache phase of migraine attacks among migraine patients compared with controls.

Methodology

A prospective, case-control study was conducted at a tertiary care center in Palakkad, Kerala from January 2022 to August 2023. This study included 50 migraine patients and 50 age/gender-matched controls. Adults aged 20-40 years with a more than three-year history of migraine were included in this study and those who had systemic or ocular pathologies were excluded. All 100 subjects underwent complete ocular examination, including full threshold 24-2 automated perimetry for visual field analysis and optical coherence tomography for analyzing RNFL thickness. Statistical analysis was done using SPSS Statistics Version 25 (IBM Corp., Armonk, NY, USA).

Results

In this study, the average age for cases was 29.24 ± 5.10 years, and for controls was 30.12 ± 6.20 years. Gender distribution was identical between cases and controls with 29 (58%) females and 21 (42%) males. Among the 50 migraine patients, 22 (44%) had generalized, while 28 (56%) had localized field defects during the headache phase of migraine attacks. There was a statistically significant (p < 0.001) difference in superior quadrant RNFL thickness between cases (114.08 ± 12.25) and controls.

Conclusions

We found that RNFL thinning in the superior quadrant and non-specific localized visual field changes occur during migraine attacks. We conducted this study in a tertiary care center as very few studies in our country have revealed visual field changes during migraine headache attacks.

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