Are Retinal and Peripapillary Blood Flows Affected during Migraine Attack?

Migraine pathophysiology is complex and partially includes the vasculature. This study compared retinal and peripapillary blood flow parameters in migraine patients during an attack with healthy controls using optical coherence tomography angiography (OCTA). A prospective clinical study was conducted including 52 eyes from 26 migraineurs and 48 eyes from 24 healthy controls. OCTAs were performed with RTVue XR Avanti using AngioVue software. OCTA imaging was performed during the attack period in migraineurs before any treatment for the attack. Vascular densities in the whole image, fovea, superior hemisphere, inferior hemisphere, and temporal, superior, nasal, and inferior regions of the parafoveal area and in the superficial and deep capillary plexuses were acquired and statistically analysed. The flow density parameters were measured in the superficial retinal capillary plexus, deep retinal capillary plexus, outer retinal capillary plexus, and choriocapillaris layers of the macula in a 3-mm diameter area. The peripapillary flow densities were measured for the optic nerve head, vitreous, radial peripapillary capillaries, and choroid in a 4.50-mm diameter area around the optic disc. Vascular density measurements in the superficial plexus were similar between migraineurs and controls (p> .05). Vascular densities in the deep capillary plexus were similar between groups (p> .05), except in the deep superior area (p= .05). Flow areas in the nerve head, vitreous, peripapillary capillary, and choroid segments were similar between migraineurs and controls (p> .05). Macular thickness parameters were also similar between groups (p> .05). The results suggest that an acute migraine attack does not affect retinal or peripapillary blood flow.