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Retinal nerve fiber layer changes in migraine: a systematic review and meta-analysis

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Abstract

Background

Migraine is one of the most common disabling diseases in the world. Its recurrent attacks may lead to abnormalities in the structure of the brain and retina. An increasing number of studies have investigated retinal nerve fiber layer (RNFL) thickness alterations in migraine by the optical coherence tomography (OCT); however, no consensus has yet reached.

Method

We searched Pubmed, Embase, and Web of Science databases to identify studies that investigated RNFL thickness in migraine by OCT measurement and performed a meta-analysis of eligible studies.

Results

Twenty-six studies were included in the meta-analysis, comprising 1530 migraine patients and 1105 healthy controls. The mean RNFL thickness was thinner in the migraine group compared to the control group (SMD =− 0.53). In the subgroup analyses, RNFL thickness were decreased most significantly in the superior (SMD = − 0.71) and inferior (SMD = − 0.63) quadrants among all quadrants. Migraine with aura (SMD = − 0.91) showed a greater effect size of RNFL thickness reduction than migraine without aura (SMD =− 0.47). Spectral-domain OCT (SMD = − 0.55) seems more sensitive to detect RNFL thickness reduction than time-domain OCT (SMD = − 0.44). In addition, age, sex, disease duration, attack frequency, and intraocular pressure were not significantly associated with RNFL thickness.

Conclusions

The findings from our comprehensive meta-analysis with large datasets strengthen the clinical evidence of the RNFL thickness reduction in migraine. RNFL thickness via spectral-domain OCT measurement demonstrates the potential role in differentiating patients with migraine, especially migraine with aura, from healthy controls.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81601161).

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Author notes

  1. HongJie Zhang, PanWen Zhao, and PingLei Pan contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, People’s Republic of China

    XiaoGuang Lin, XueLing Zhang & QinQin Liu

  2. Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, West Xindu Road 2#, Yancheng, Jiangsu Province, People’s Republic of China

    ZhongQuan Yi, Hui Zhang, PanWen Zhao & PingLei Pan

  3. Department of Ophthalmology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, People’s Republic of China

    RuYuan Cai, ChaoChun Chen & HongJie Zhang

  4. Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, West Xindu Road 2#, Yancheng, 224001, Jiangsu Province, People’s Republic of China

    PingLei Pan

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  1. XiaoGuang Lin
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Contributions

HJZ, PWZ, and PLP conceived ideas and designed research, QQL, XGL, ZQY, and HZ contributed to search databases, screen literature, extract data and perform statistical analysis. ZQY, HJZ, CCC, and RYC provided guidance on the software. XGL and ZQY drafted the manuscript. PWZ, HJZ, and PLP participated in the editing and revision of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to PanWen Zhao or PingLei Pan.

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Supplementary Information

Supplementary Figure 1

Sensitivity analysis of studies meeting the eligibility criteria CI, confidence intervals (PNG 2211 kb)

High Resolution Image (TIF 1434 kb)

Supplementary Figure 2

Meta-analysis of the mean RNFL thickness of migraine patients and healthy controls measured in both eyes RNFL, retinal never fiber layer; SMD, standard mean difference; CI, confidence intervals (PNG 2392 kb)

High Resolution Image (TIF 1436 kb)

Supplementary Figure 3

Meta-analysis of the mean RNFL thickness of migraine patients and healthy controls measured in random single eye RNFL, retinal never fiber layer; SMD, standard mean difference; CI, confidence intervals (PNG 2258 kb)

High Resolution Image (TIF 1058 kb)

Supplementary Figure 4.

Meta-analysis of the mean RNFL thickness of migraine patients and healthy controls measured in the right eye RNFL, retinal never fiber layer; SMD, standard mean difference; CI, confidence intervals (PNG 2305 kb)

High Resolution Image (TIF 1251 kb)

Supplementary Figure 5.

Meta-analysis of the mean RNFL thickness of migraine patients and healthy controls measured in the left eye RNFL, retinal never fiber layer; SMD, standard mean difference; CI, confidence intervals (PNG 2414 kb)

High Resolution Image (TIF 1673 kb)

Supplementary Table 1

(DOCX 19 kb)

Supplementary Table 2

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Supplementary Table 3

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Supplementary Table 4

(DOCX 17 kb)

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Lin, X., Yi, Z., Zhang, X. et al. Retinal nerve fiber layer changes in migraine: a systematic review and meta-analysis. Neurol Sci 42, 871–881 (2021). https://doi.org/10.1007/s10072-020-04992-4

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