![]() Barash also acknowledged that future studies should include females, as migraine tends to affect more women than men (with a lifetime prevalence of 43% for women-about 28 million women in the U.S. Barash explained that while he did not account for potential medication use, “it would be interesting to see what the results might be if patients are on vasodilators.”ĭr. Question and answer session During a question and answer session at ASRS, Dr. ![]() Barash recommended further studies with a greater number of enrolled patients to corroborate his findings. “There were acute reductions in retinal perfusion in real time, and this may explain the retinal thinning and progression of glaucoma that you see in patients with migraine," he noted.ĭr. OCT-A detected microcirculatory disturbances during acute post-aural migraine attacks “may be an important took in elucidating the pathophysiological relationship between migraine, aura, and ischemia,” Dr. ![]() There were no statistically significant changes to macular perfusion noted between baseline and aura, nor were there significant changes to the peripapillary perfusion between baseline, aura or post-aural migraine. The overall perfusion density was significantly decreased during post-aural migraine as compared to that of aura in both the superficial and deep macula on 6圆 mm scans (p=0.00131 and p=0.00689, respectively see figure). Study Results Overall macular perfusion density was significantly decreased during post-aural migraine as compared to that of baseline in the superficial and deep macula 6圆 mm scans (p=4.2 x10^-8 and p=0.03206, respectively), and the deep macula on 3x3 mm (p=0.01996). (Patients with migraine without aura were not included.) The analysis included angiographic densities of macular superficial and deep capillary layers, and the radial peripapillary capillary layer. Patients underwent 3x3 mm and 6圆 mm macular and 4.5x4.5 mm optic nerve head OCT-A scans in both eyes during a baseline day without migraine, and during five episodes of aura and immediate post-aural migraine. Barash recruited three male patients who had migraine with aura. “We wanted to know-what happens to retinal perfusion during migraine?” he said. Barash and colleagues aimed to identify changes to macular and peripapillary retinal perfusion during migraine with aura. Using optical coherence tomography angiography (OCT-A), Dr. “Aura may indicate more severe ischemia that predisposes to complications,” Dr. Patterns not fully explained The pattern of migraine aura cannot be fully explained by changes in cerebral blood flow, and the areas of decreased blood flow do not directly correspond to the cortical areas responsible for the aura. “During aura, there are changes in the cerebral blood flow,” he said, noting that people who have migraine also have brains that are more easily damaged, and they need a higher blood flow to survive focal ischemia. ![]() 2Īura (which includes visual disturbances and/or other neurologic symptoms) occurs in about 25% of patients who experience migraine, 1 and is often a cause for referral to an ophthalmologist. Whether or not migraine can significantly increase the risk of developing primary open-angle glaucoma remains controversial. Barash pointed out that these associations are stronger for those patients who have migraine with aura than without aura. Speaking at the 2019 American Society of Retina Specialists annual meeting in Chicago, Dr. 1 It has been associated with stroke and myocardial infarction, as well as retinal vessel occlusion, ischemic optic neuropathy and normal tension glaucoma, according to Alexander Barash, MD, New York Medical Care. Migraine affects 12% of the population, and is the third most prevalent illness in the world.
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