How Retinal Imaging Reveals Alterations During Migraine Attacks: Katherine Podraza, MD, PhD


The headache specialist at the Hartford Healthcare Headache Center discussed a study that explored changes in the vasculature and retinal blood perfusion of the eye during migraine attacks. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"We saw that both migraine groups, migraine with aura and migraine without aura, have a drop in retinal perfusion in the macular region, specifically the parafoveal region of about 7%. We are seeing changes under profusion of the retinal and migraine attack."

Optical coherence tomography angiography (OCTA) is a rapid and nonintrusive imaging method used in clinical practice to assess the retinal microvasculature precisely.1 Although there have been several studies that explored the retinal layer structure and microvasculature in patients with migraines using OCT/OCTA, there is still a limited amount of research that analyzes the alterations in the retinal microvasculature, specifically, during a migraine attack.

A recent study investigated the retinal microvasculature in a population of patients who had migraine with aura (MA) and migraine without aura (MO), looking at the changes in the interictal and ictal state using a novel OCTA-based retinal perfusion measure. For the interictal analysis, researchers enrolled 37 patients with MA (68 eyes), 30 patients with MO (56 eyes), and 20 healthy controls (38 eyes). Among these patients, 13 patients with MA (24 eyes) and 8 patients with MO (14 eyes) had given consent to scans during a migraine attack.1

At the 2023 AHS Annual Meeting, held June 15-18, in Austin, Texas, lead author Katherine Podraza, MD, PhD, a headache specialist at Hartford Heathcare Headache Center, gave the Early Career Award Lecture that was based on the study. During the lecture, she noted that the results showed a distinct pattern of reduced retinal blood perfusion interictally in the foveal retina in patients with MA when compared to MO, which supported the potential use of OCTA as a biomarker for migraine.

Podraza sat down with NeurologyLive® at the meeting to provide more information about the study she presented regarding migraine and eye vasculature. She talked about the focus of the study and how retinal imaging technology was used to examine the vasculature of the eye. Podraza also discussed the findings that were observed, including the related changes in blood perfusion and vasculature in patients with migraine with aura compared with those without aura.

Click here for more coverage of AHS 2023.

1. Podraza K, Bangera N, Feliz A, Charles A. Analysis of retinal microvasculature during a migraine attack using an Optical Coherence Tomography Angiography based retinal perfusion measure. Presented at: AHS Annual Meeting, 2023; June 15-18; Austin, TX. EC-1.
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