While migraines have originally been thought to be a benign disorder, recent brain imaging studies have shown that migraines may be a risk factor for certain structural changes in the brain, such as white matter alterations and lesions without proper blood supply. While the exact pathophysiology of migraines is still unknown, there are certain mechanisms thought to lead to neurovascular (related to nerves and blood vessels) dysfunction in those with migraines. 

Systemic vascular diseases, such as migraines, are known to occur in glaucoma patients. Current research explores whether or not migraines are a risk factor for the development of open-angle glaucoma (OAG), the most common form of glaucoma.*

What they did

In a retrospective cohort study, researchers studied 17,283 subjects with migraines in the study cohort and randomly selected 69,132 subjects from a database for the comparison group. They pulled names from Taiwan’s National Health Insurance Research Database (NHIRD). All participants were 20 years of age or older, and none of them had received a glaucoma diagnosis before enrollment.

The mean age of the study cohort was approximately 45 years old, and almost 75% of the patients in the study were female. Participants were individually traced for a 10-year period to identify those who were diagnosed with open-angle glaucoma. Researchers looked at participants’ related medical conditions (comorbidities) and assessed risk factors for OAG in those suffering from migraines. They also assessed for the diagnosis of OAG (primary OAG and low-tension glaucoma, two types of OAG) in patients with migraines.

What they found

The investigators found that the participants with migraines had more vascular comorbidities than the comparison cohort. 

The prevalence of these related medical conditions in the migraine patient group was as follows:

• 16.6% for hypertension
• 8.4% for chronic obstructive pulmonary disease
• 6.7% for hyperlipidemia
• 5.5% for ischemic heart disease
• 4.7% for uncomplicated diabetes mellitus
• 3.9% for cerebrovascular disease
• 0.8% for peripheral vascular disease

As for OAG, the researchers found that age, hyperlipidemia, and diabetes were all risk factors for developing OAG. When adjusting for these factors, however, the risk of developing OAG among patients with migraine fell short of statistical significance. 

What they did find was that patients with migraines—but without comorbidities—were found to have more than a 1.5-fold greater risk of developing OAG than the comparison cohort.

What it means

Despite there being a higher prevalence of comorbidities in the cohort with migraines than the control group, researchers found that there was an increased risk of OAG in patients with migraine without comorbidities. There was also a significant association between migraine and OAG in those who were 50 years old or younger.

*Huang, J.-Y., Su, C.-C., Wang, T.-H., & Tsai, I.-J. (2019, Feb. 13). Migraine and increased risk of developing open angle glaucoma: a population-based cohort study. BMC Ophthalmology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375150/

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