Risk of Retinal Artery Occlusion in Patients with Migraine. American journal of ophthalmology Al-Moujahed, A., Tran, E. M., Azad, A., Vail, D., Ludwig, C. A., Pasricha, M. V., Rosenblatt, T. R., Callaway, N. F., Moshfeghi, D. M. 2020


PURPOSE: To determine if migraine is associated with increased risk of retinal artery occlusion (RAO).DESIGN: Retrospective cohort study METHODS: Setting: A large insurance claims database.PARTICIPANTS: Patients with migraine and matched controls without migraine between 2007 to 2016.PROCEDURES: Cox proportional hazard regression models were used to investigate the association between migraine and risk of all RAO, central RAO (CRAO), branch RAO (BRAO), and "other" RAO, which includes transient and partial RAO.MAIN OUTCOME MEASURES: Incidence of all RAO, including CRAO, BRAO, and other RAO, following first migraine diagnosis.RESULT: There were 418,965 patients with migraine who met study criteria and were included in the analysis with the appropriate matched controls. Among the 418,965 patients with migraine, 1,060 (0.25%) were subsequently diagnosed with RAO, whereas only 335 (0.08%) of the patients without migraine were diagnosed with RAO. The hazard ratio (HR) for incident all RAO in patients with migraine compared with those without migraine was 3.48 (95% Confidence Interval (CI): 3.07 - 3.94; P <0.0001]. This association was consistent across all types of RAO, including CRAO (HR = 1.62; 95% CI: 1.15 - 2.28; P=0.004) BRAO (HR 2.09; 95% CI 1.60 - 2.72; P <0.001), and other types of RAO (HR 4.61; 95% CI 3.94 - 5.38; P <0.001). Patients with migraine with aura had a higher risk for incident RAO compared with those with migraine without aura (HR = 1.58; 95% CI: 1.40 - 1.79; P <0.001). This association was consistent for BRAO (HR = 1.43; 95% CI 1.04 - 1.97; P <0.03) and other types of RAO (HR = 1.67; 95% CI 1.45 - 1.91; P <0.001), but was not statistically significant for CRAO (HR = 1.18; 95% CI 0.75 - 1.87; P = 0.475). Significant risk factors for this association included increased age, male sex, acute coronary syndrome, valvular disease, carotid disease, hyperlipidemia, hypertension, retinal vasculitis and/or inflammation, and systemic lupus erythematosus.CONCLUSIONS: Migraine is associated with increased risk of all types of RAO and migraine with aura is associated with increased risk of RAO compared with migraine without aura.

View details for DOI 10.1016/j.ajo.2020.11.004

View details for PubMedID 33359716