Topographic changes measured by the swept source optical coherence tomography in retinal nerve fiber layer, optic nerve head and macula in children with migraine

DOI: https://doi.org/10.1007/s13760- 019- 01123- 5

Abstract-Summary Certain RNFL quadrants and optic disc parameters revealed significant differences between the patients and controls.

In the right and left eyes of children with migraine, nasal quadrant RNFL was significantly thicker than that in healthy subjects (88.82 ± 11.03 vs 77.80 ± 13.77, P = 0.004 for right eyes and 87.71 ± 11.79 vs 77.80 ± 13.77, P = 0.01 for left eyes).

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3 Diagnosis

Temporal quadrant RNFL in the left eyes was thinner (78.67  ±  9.57 vs

84.44 ± 9.68, P = 0.04).

There were significant expansions in cup volumes in favor of the patients for right and left eyes (0.15 ± 0.19 vs 0.05 ± 0.05, P = 0.03 and 0.17 ± 0.14 vs 0.05 ± 0.05, P = 0.001, respectively).

The only significant difference between the left and right eyes of the migraineurs

was the RNFL thickness in the superior quadrant.

Ganglion cell layer thickness did not differ between the right eyes, left eyes and

controls.

Children with migraine showed significant variations in specific RNFL and optic

disc parameters compared to control subjects.

Introduction Migraine and tension-type headache are the most common types of headache in children [455].

The prevalence of migraine increases from 3% in the preschool period to 8–23%

in high school years [456–458].

In 14% of young children diagnosed with migraine without aura, symptoms in

adolescence evolve to those of episodic tension-type headache [459].

The common symptoms of migraine are unilateral headache, photophobia, pho- nophobia, nausea, dizziness, worsening of pain during physical activity and the aura which increases with time [460, 461].

The most common premonitory symptoms of migraine in childhood are fatigue,

emotional changes and neck stiffness [145].

Learning disabilities are common among children with migraine, both intelli-

gence deficit and cognitive impairment increase in early childhood [462–466].

Methods OCT is a reliable, reproducible, non-invasive, transpupillary diagnostic technique that enables quantitative in vivo high-resolution measurements of ONH, peripapil- lary retinal nerve fiber layer (RNFL), ganglion cell layer and choroid layer thick- nesses [467, 468].

For the measurements of RNFL and ONH parameters, a peripapillary circle of 3.4 mm diameter is automatically centered on the optic disc, and for the measure- ments of the average or sectoral GCIPL and GCC thicknesses, a circle of 6  mm diameter is automatically centered on the fovea.

Distributed average and sectoral values of macular GCIPL thickness, macular GCC layer thickness, peripapillary RNFL thickness and ONH parameters were compared between normal and patient eyes using the independent sample t test. The diagnostic accuracy of each retinal layer thickness and ONH parameter to differentiate normal and patient eyes was identified by calculating the areas under the receiver operating characteristic (ROC) curves.

Results The mean ages of the migrainous children and control group were 14.17  ±  2.61 (9–17 years) and 13.62 ± 2.45 (9–18 years), respectively, and no significant differ- ence was present between them (P = 0.45).

3.4 Neuroimaging

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The vast majority of patients and controls consisted of girls. Certain RNFL quadrants and ONH parameters showed significant differences

between the patients and controls.

The areas under the ROC curves (AUC) were calculated to determine the ability

of ocular parameters to distinguish between the patient and normal eyes.

Discussion To the results from adults, nasal quadrant RNFL in this study was significantly thicker in children with migraine.

Unlike the thinning of RNFL which has generally been reported in adult migraine, substantial RNFL thickening in nasal quadrant was detected in migrainous children in the current study.

Significant difference in superior quadrant RNFL thickness between the right and left eyes brings into mind the laterality in contrast to the study by Güneş and others In children with migraine, temporal quadrant RNFL thinning and enlarge- ments of the disc area and cup volume resemble those seen in patients with low tension glaucoma.

In this study, significant differences were surprisingly found with SS-OCT in many retinal or optic disc parameters in children with migraine as opposed to adults.

Acknowledgement A machine generated summary based on the work of Yener, Arif Ülkü; Yılmaz, Deniz. 2019 in Acta Neurologica Belgica.

Retinal vascular density evaluation of migraine patients with and without aura and association with white matter hyperintensities