Abstract
BackgroundMigraine is a multifactorial disorder with complex neuronal and vascular mechanisms that encompasses a wide clinical spectrum of symptoms, including ocular manifestations. Dry eye disease and dysfunction of ocular somatosensory pathways have been implicated in the pathogenesis. The current study investigates the association between a dysfunctional tear film and ocular aberrations with migraine.MethodsSixty eyes of 30 patients with migraine and 60 eyes of 30 controls were studied. Dry eye evaluation included Schirmer’s test, tear film break-up time, corneal esthesiometry and lipid layer analysis using Lipiview® interferometer. Wavefront aberrations were measured using Optical Path Difference before performing the dry eye evaluation. The intraocular light scatter was quantified using the objective scatter index (OSI) of the optical quality analysis system. Measured parameters were compared between the migraine and the control group using independent sample t-test. Statistical analysis was performed using commercial software. A p value of ≤ 0.05 was considered statistically significant.ResultsThere were 19 females and 11 males in each group. Statistically significant difference was found between the two groups with respect to total aberrations (p = 0.049), higher order aberrations (p = 0.009), coma (p = 0.03), spherical aberrations (p = 0.018), Lipiview interferometric coloric units (p < 0.001) and OSI (p < 0.001). Trefoil (p = 0.26) and TBUT (p = 0.398) were not significantly different between both groups.ConclusionsOcular aberrations are higher in patients with migraine as compared with controls. Tear film abnormalities add to the aberrations in otherwise asymptomatic patients and may also be associated with migraineous attacks. Treating the ocular surface to obtain a healthy tear film might introduce a potential modifiable factor in the prevention of migraneous attacks.
Highlights
Migraine is a multifactorial disorder with complex neuronal and vascular mechanisms that encompasses a wide clinical spectrum of symptoms, including ocular manifestations
The current study looks at the correlation between migraine and a dysfunctional tear film as well as ocular aberrations in migraine patients as well as controls
Patients with a confirmed diagnosis of chronic migraine with aura according to international classification of headache disorders were included in the study after neurological consult
Summary
Migraine is a multifactorial disorder with complex neuronal and vascular mechanisms that encompasses a wide clinical spectrum of symptoms, including ocular manifestations. Dry eye disease and dysfunction of ocular somatosensory pathways have been implicated in the pathogenesis. The current study investigates the association between a dysfunctional tear film and ocular aberrations with migraine. The tear film is the first and most important refractive surface of the eye [7]. An unhealthy ocular surface can lead to increased tear film break-up and result in image degradation secondary to increased wavefront aberrations [8]. Changes in the visual environment that lead to evaporative dry eye and alterations in the ocular surface may influence aberrations. Dry eye disease is noted to be more frequent in migraine patients with a greater presence of aura, longer duration of attacks and longer disease durations [9]. The trigeminal nerve is the common afferent nerve for the migraine pathway as well as for dry eye associated ocular
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