Macular Vessel and Perfusion Density Are Reduced in Patients With Migraine

Patients with migraine are more likely to have reduced macular vessel and perfusion density, according to research published in Photodiagnosis and Photodynamic Therapy. 

Researchers enrolled 86 participants including individuals with migraine with aura ([MWA]; n=23), migraine without aura ([MWOA]; n=31) and healthy controls (n=32) in the analysis. Participants underwent comprehensive ophthalmic examinations consisting of optical coherence tomography angiography (OCTA) imaging, macular angiography, and optic disc angiography scans. The retinal vessel and perfusion densities of the macula and optic nerve head were compared between groups.

According to the report, patients with migraine tended to have larger foveal avascular zone (FAZ) area (P =.001) and perimeter (P =.009), while exhibiting reduced macular center vessel density ([cVD]; P =.005), center perfusion density ([cPD]; P =0.000), and temporal macular outer ring (or) VD compared with control individuals.

FAZ circularity was reduced among participants in the MWA group compared with participants in both other cohorts and average inner ring (ir) VD was lower among MWA group individuals compared with control individuals.

Patients in the MWA group also tended to have reduced inferior irVD and temporal orVD compared with participants in the other groups.

Higher migraine disability assessment score (MIDAS) and attack frequency was associated with reduced central VD and PD, inner ring VD and PD of the macula, and optic nerve head (ONH). FAZ area was positively correlated with MIDAS and attack frequency. Age and macular irVD and irPD were also associated (r = -0.281; P =.008 and r = -0.325; P =.002, respectively).

“[T]he enlarged FAZ area and perimeter, and decreased FAZ Circularity Index in patients with migraine may indicate the risk of retinal microvascular disease,” according to the researchers. “The association of OCTA changes and migraine severity in this study, demonstrated by MIDAS and migraine frequency, is supportive of the possibility of the migraine severity affecting the retinal vasculature.”

Study limitations include a small sample size, failure to evaluate the deep capillary plexus, and the absence of longitudinal data.