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Microvascular involvement in migraine: an optical coherence tomography angiography study

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Abstract

Objective

The aim of this study was to evaluate the microvasculature of the macula and the optic nerve in patients affected by migraine with aura (MA) and without aura (MO) by optical coherence tomography angiography (OCTA), comparing the findings with healthy controls (HC).

Methods

We collected data from ocular and orthotic examinations, including eye motility, intraocular pressure measurement, best-corrected visual acuity (BCVA) measurement, objective refraction measurement, fundus examination, macular and optic disk OCTA examination. All subjects were imaged with solix fullrange OCT. The following OCTA parameters were recorded: macular vessel density (VD), inside disc VD, peripapillary VD, disc whole image VD, fovea choriocapillaris VD, fovea VD, parafovea VD, peripapillary thickness, fovea thickness, parafovea thickness, macular full retinal thickness, and foveal avascular zone (FAZ) parameters. Clinical and demographical data about migraine patients were collected by a neurologist.

Results

We included 56 eyes from 28 patients with a diagnosis of MO, 32 eyes from 16 patients with a diagnosis of MA, and 32 eyes from 16 HC subjects. The FAZ area was 0.230 ± 0.099 mm2 in the MO group, 0.248 ± 0.091 mm2 in the MA group and 0.184 ± 0.061 mm2 in the control group. The FAZ area was significantly larger in the MA group than in the HC group (p = 0.007). The foveal choriocapillaris VD was significantly lower in MA patients (63.6 ± 2.49%) when compared with MO patients (65.27 ± 3.29%) (p = 0.02).

Conclusion

An impairment of retinal microcirculation can be detected in patients with MA, as demonstrated by the enlargement of FAZ. Moreover, the study of choroid circulation may reveal microvascular damage in patients with migraine with aura. OCTA is a useful non-invasive screening tool for the detection of microcirculatory disturbance in patients with migraine.

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Funding

No funding declared.

Author information

Author notes

  1. Marina Romozzi and Giovanni Cuffaro have contributed equally to the work.

  2. Gustavo Savino and Catello Vollono share the senior authorship.

Authors and Affiliations

  1. Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy

    Marina Romozzi, Eleonora Rollo, Paolo Calabresi, Serenella Servidei & Catello Vollono

  2. Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

    Marina Romozzi, Eleonora Rollo & Paolo Calabresi

  3. Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Giovanni Cuffaro, Roberta Mattei, Sofia Marcelli, Stanislao Rizzo & Gustavo Savino

  4. Dipartimento di Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, Rome, Italy

    Stanislao Rizzo & Gustavo Savino

  5. Neurofisiopatologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy

    Serenella Servidei & Catello Vollono

Authors
  1. Marina Romozzi
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  2. Giovanni Cuffaro
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  3. Eleonora Rollo
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  4. Roberta Mattei
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  5. Sofia Marcelli
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  6. Stanislao Rizzo
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  8. Serenella Servidei
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  9. Gustavo Savino
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  10. Catello Vollono
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Corresponding author

Correspondence to Catello Vollono.

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Ethical standard statement

The study was approved by the Ethical Committee of the Università Cattolica del Sacro Cuore (protocol ID 4155/2021).

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Romozzi, M., Cuffaro, G., Rollo, E. et al. Microvascular involvement in migraine: an optical coherence tomography angiography study. J Neurol 270, 4024–4030 (2023). https://doi.org/10.1007/s00415-023-11697-z

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  • DOI: https://doi.org/10.1007/s00415-023-11697-z

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