| Summary: | Migraine is one of the world’s most debilitating disorders, and it has recently
been shown that changes in the retina can be a potential biomarker for the
disease. These changes can be detected by optical coherence tomography
(OCT), which measures retinal thickness, and optical coherence tomography
angiography (OCTA), which measures vessel density. We searched the
databases Google Scholar, ProQuest, Scopus, and Web of Science for studies
in English using OCT and OCTA in migraineurs, using the search terms “optical
coherence tomography,” “OCT,” “optical coherence tomography angiography,”
“OCTA” and “migraine.” We found 73 primary studies, 11 reviews, and 8 metaanalyses pertaining to OCT and OCTA findings in migraineurs. They showed
that migraineurs had reduced retinal thickness (via OCT), retinal vessel density,
and greater foveal avascular zone area (via OCTA) than controls. OCTA changes
reflect a perfusion compromise occurring in migraineurs as opposed to in
healthy controls. OCT and OCTA deficits were worse in migraine-with-aura and
chronic migraine than in migraine-without-aura and episodic migraine. Certain
areas of the eye, such as the fovea, may be more vulnerable to these perfusion
changes than other parts. Direct comparison between study findings is difficult
because of the heterogeneity between the studies in terms of both methodology
and analysis. Moreover, as almost all case–control studies were cross-sectional,
more longitudinal cohort studies are needed to determine cause and effect
between migraine pathophysiology and OCT/OCTA findings. Current evidence
suggests both OCT and OCTA may serve as retinal markers for migraineurs,
and further research in this field will hopefully enable us to better understand
the vascular changes associated with migraine, perhaps also providing a new
diagnostic and therapeutic biomarker.
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