Application Of Enhanced Depth Imaging Optical Coherence Tomography In Migraine

Purpose:Migraine is a nervous system disease,and its pathogenesis is still unclear.After the pathological damage,neuron degeneration will appear in the central nervous system.Retrograde degeneration of neurons is also seen in the visual pathway.Enhanced depth imaging optical coherence tomography(EDI-OCT)is a noninvasive and repeatable test.The results are not affected by subjective factors of patients.Its high resolution can detect the slightest damage of the structure.The aim of this study is to measure ocular posterior structure of patients with aura and migraine without aura by EDI-OCT,and to find out whether the structure is abnormal.We also try to verify the phenomenon of transneuronal retrograde degeneration,and to explore new biological markers for migraine.Methods:We recruited patients diagnosed with migraine consecutively in International Headache Center of Chinese PLA General Hospital from 2015 August to 2016 July.According to the inclusion and exclusion criteria,we selected 30 patients with migraine aura,60 patients with migraine without aura,30 cases as healthy controls.All the participants underwent nervous system and ophthalmic examination to exclude the participants with nervous system disorders or ophthalmic diseases.We used Heidelberg EDI-OCT to measure ocular posterior structure of the participants,and to analyze the data statistically.Results:The nasal of peripapillary retinal nerve fiber layer thickness(pRNFLT)was significantly thinner in migraine with aura group than those in migraine without aura group and healthy control group(p=0.007).The RNFL and ganglion cells thickness of central macular were significantly thinner than those in the other two groups(p=0.043,p=0.043).The choroid thickness in subfovea,500 ?m temporal and 500 ?m nasal to fovea were significantly thinner than those in the other two groups(p=0.042,0.009,0.042).The temporal inferior of pRNFLT was significantly thinner in photophobia groups than that in nonphotophobia group(p=0.007),and temporal inner of macular was significantly thinner in photophobia groups than that in nonphotophobia group(p=0.009).The two above area were also thinner in autonomic nerve response group(p=0.047,0.002),and the choroid thickness in subfovea was significantly thinner in the autonomic nerve response group than that in nonautonomic nerve response group(p=0.037).The nasal of pRNFLT in migraine with aura was negatively correlated with the product of the duration and frequency(p=0.046).The temporal pRNFLT was significantly thinner in course of more than 10 years group than that in course of less than 10 years group(p=0.008).Conclusion:The retinal nerve fiber layer thickness,macular thickness and choroid thickness were thinner in patients with migraine aura.The longer the clinical course last,the more obvious the structure changes.Retrograde transneuronal damage and the activation of trigeminal nerve vessel system may be the main causes of structural changes in migraine patients.EDI-OCT can detect early pathological changes of nerve system,and it also had higher sensitivity in migraine patients.Retinal nerve fiber layer and retinal ganglion cells may be a new biological marker of neurological function damage.