| Purpose. Migraine has been shown to be positively associated with some forms of pressure independent glaucoma, though the pathological contribution, if any, has never been determined. It has been suggested that vasospasm of the blood supply to the optic nerve, which is similar to the cerebral vasospasm in migraine, may occur, possibly contributing to glaucomatous changes in the optic disc. The purpose of this study is to investigate possible topographical differences in the optic nerve between migraine sufferers and normal age matched control subjects. Identification of optic disc topographical differences may further support the association between migraine and glaucoma development and suggest a possible causative role of vasospasm.;Methods. Sixty consecutively seen patient-volunteers (30 subjects in migraine group: mean age 37.7 years, range from 19 to 66 years, 28 females and 2 males; 30 subjects in the control group: mean age 37.6 years, range from 19 to 61 years, 29 females and 1 male) were categorized as either migraine patients or control group subjects. All patients had been medically diagnosed with a migraine syndrome and were being treated with migraine prophylaxis medication. Optic nerve head topographical analysis was performed using a confocal scanning laser ophthalmoscope (HRT II - Heidelberg Retinal Tomograph II, Advanced Glaucoma Suite version 3.0, Heidelberg Engineering, Heidelberg, Germany). The optic nerve parameters evaluated were the rim area, rim volume, cup shape measurement, height variation contour and mean nerve fiber layer thickness as these are felt to be the most discriminating for glaucoma. Findings were evaluated using generalized estimating equations to address the correlation between the eyes to validate the parameter estimates allowing the hypothesis testing results to be replicable.;Results. No significant differences were found in any of the optic nerve parameters between the two groups.;Conclusions. Topographical changes of the optic nerve occur in glaucoma. Migraine, a known vasospastic entity has been suggested as a possible contributory factor in some types of glaucoma. This study indicates that the optic nerve parameters as measured by the HRT II do not differ between migraine sufferers and age matched control subjects. This study indicates that there appears to be no changes imparted to the optic nerve disc in patients with a known vasospastic condition.;Key words. migraine, vasospasm, glaucoma, optic disc topography. |
