MIGRAINE AND GLAUCOMA

 

Migraine is a primary debilitating headache disorder affecting 10% to 15% of people worldwide. The cumulative lifetime incidence of migraine was reportedly 43% in women and 18% in men in the US. The prevalence is believed to be lower in Asians than in Caucasians.

Migraine is linked to endothelial dysfunction and is considered a systemic vasculopathy. Interestingly, systemic vascular diseases also occur in glaucoma patients and are considered to be risk factors for the development of glaucoma.

Whether migraine is simply a concomitant condition in glaucoma patients or a risk factor per se for glaucoma remains unknown.

Charles defined migraine as a disorder with both vascular and neural involvement as part of its pathophysiology.

Various reports have found migraine to be a significant risk factor for primary open-angle glaucoma (POAG).

However, the association between migraine and glaucoma is still controversial.

Xu et al. performed a systemic review and meta-analysis to study this association. 

8 case–control and 3 nested case–control/cohort studies revealed a statistically significant relationship between migraine and POAG.

Subjects who suffered from migraine had a 24% higher risk of developing POAG when compared to those who had never suffered from migraine.

Lin et al. have also found that subjects with migraine were 1.2 times more likely to have POAG compared with those without migraine.

The Glaucoma Inheritance Study found that migraine history was significantly associated with familial POAG compared to those with sporadic POAG, implying that migraine is an important heritable risk factor for glaucoma.

The mechanism for the association between the two conditions is attributed to vascular dysregulation, which occurs in some glaucoma patients.

REFERENCES:

Xu C, Li J, Li Z, Mao X. Migraine as a risk factor for primary open-angle glaucoma: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97:e11377.

Chen HY, Lin CL, Kao CH. Does Migraine Increase the Risk of Glaucoma?: A Population-Based Cohort Study. Medicine (Baltimore). 2016 May;95(19):e3670.

Huang JY, Su CC, Wang TH, Tsai IJ. Migraine and increased risk of developing open-angle glaucoma: a population-based cohort study. BMC Ophthalmol. 2019;19:50.

Lin HC, Chien CW, Hu CC, et al. Comparison of comorbid conditions between open-angle glaucoma patients and a control cohort: a case-control study. Ophthalmology 2010;117:2088–95.

Ahmad SS. Controversies in the vascular theory of glaucomatous optic nerve degeneration. Taiwan J Ophthalmol. 2016;6:182-186.