Patients With Migraine at Increased Risk for Open-Angle Glaucoma

While the exact pathophysiology behind migraine is unknown, the condition has been associated with neurovascular dysfunction due to changes in blood vessels, hypoperfusion disorders, and microembolization. Because of this association, migraine has been linked to endothelial dysfunction and therefore considered a systemic vasculopathy. Systemic vascular diseases also present in patients with glaucoma, which has begged the question of whether migraine is a concomitant condition in glaucoma or if it is a risk factor for the disease.

According to a new study, it's the latter, with migraine being associated with a higher risk of open-angle glaucoma (OAG) compared with patients with no migraine.

The findings come from a 10-year follow-up study of 17,238 patients diagnosed with migraine between January 1, 2000, and December 31, 2010, and 69,132 matched controls from the Longitudinal Health Insurance Database.

While patients with migraine had a cumulative incidence rate of 1.29 per 1000 person-years for OAG, the healthy controls had an incidence rate of 1.02.

“Various studies have shown that glaucoma is associated with many risk factors, including age, race, diabetes, hypertension, and vascular disorders,” noted the researchers. When adjusting for these factors, the risk of developing OAG among patients with migraine fell short of statistical significance (P = .0682).

However, among patients with no comorbidities, the risk of developing OAG was 1.68 times greater among patients with migraine than the controls. Similarly, there was a significant association between migraine and OAG in those who were younger than 50 years.

Comorbid hypertension, chronic obtrusive pulmonary disease, hyperlipidemia, ischemic heart disease, diabetes, cerebrovascular disease, and peripheral vascular disease were all more common among patients with migraine compared with the controls. Notably, 16.6% of patients with migraine had hypertension compared with 11.8% of controls, 6.7% of patients with migraine had hyperlipidemia compared with 4.5% of controls, and 3.9% of patients with migraine had cerebrovascular disease compared with 2.1% of controls.

Looking at these comorbidities, the researchers found that age (adjusted hazard ratio [HR], 1.03]), hyperlipidemia (adjusted HR, 1.54), and diabetes (adjusted HR, 1.61) were all risk factors for OAG.

Reference

Huang J, Su C, Wang T, Tsai I. Migraine and increased risk of developing open angle glaucoma: a population-based cohort study [published online February 13, 2019]. BMC Ophthalmol. doi: 10.1186/s12886-019-1062-9.