Peripapillary and macular choroidal vascularity index in migraine patients during acute attacks

Abstract

Purpose: To evaluate the choroidal vascularity alterations of macula and peripapillary area in migraine patients during acute migraine attacks and compare with control group participants. Methods: A total of 28 patients diagnosed with migraine (24 female and 4 male) and 28 age matched-healthy controls (21 female and 7 male) were included in this cross-sectional study. Enhanced depth imaging optical coherence tomography scans of the macula and peripapillary regions were analyzed. Images were binarized using ImageJ software (National Institutes of Health, Bethesda, MD, USA) (Figure 1). The choroidal thickness (CT), total choroidal area (TCA), luminal area (LA), stromal area (SA), and the choroidal vascularity index (CVI) were compared between the groups. Results: The subfoveal and 750 microns nasal (N750) and temporal (T750) to the fovea CT were increased in migraine patients (P=0.004, P<0.001 and P<0.001, respectively). The mean subfoveal CVI value was 65.7 ± 6.8 in migraine patients and 63.6 ± 4.8 in healthy controls (P=0.159). The mean peripapillary CT at the temporal, nasal, and inferior regions were increased in migraine group (P=0.010, P<0.001 and P<0.001, respectively). The mean CVI values of temporal and nasal quadrant in the peripapillary region were significantly increased in the migraine group as compared with the control group (P=0.005 and P<0.001, respectively). The increase TCA and LA in both fovea and peripapillary regions were statistically significant in migraine group compared to healthy controls (P<0.05 for all). Both groups had similar measured values for other parameters (P >0.05 for all). Conclusion: According to our findings, increased CT, TCA, LA and CVI values may indicate a rebound vasodilatation in the ocular blood flow, as in the vasogenic theory contributing to pain.