A Clinical Study of Retinal Nerve Fibre Layer and Ganglion Cell Layer changes in patients with Migraine at a Tertiary Care Hospital

OBJECTIVES: This study aimed to assess and compare retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness in migraine patients versus controls and to analyze differences between chronic and episodic migraine.

METHODS: A cross-sectional, case-control study was conducted from June 2022 to December 2023. A total of 100 migraine patients (33 chronic, 67 episodic) and 102 controls underwent detailed ocular evaluation using OCT. RNFL and GCL parameters were compared between cases and controls using an independent t-test. Paired t-tests assessed differences between chronic and episodic migraine, as well as between the right and left eyes.
RESULTS: Photophobia (90%) and ocular pain (85%) were the most common symptoms. Migraine patients showed a significant reduction in average (106 µm), superior (129 µm), and nasal (80 µm) RNFL thickness compared to controls. Chronic migraine patients exhibited significant thinning in the temporal (67 µm) and nasal (72 µm) RNFL quadrants and superotemporal (67 µm) and superonasal (70 µm) GCL quadrants in the right eye. Episodic migraine patients had reduced superotemporal GCL thickness (71 µm) in the left eye.
DISCUSSION AND CONCLUSION: The retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness is reduced in chronic and episodic type of migraine patients. Hence, ophthalmologists should consider the potential impact of migraine headaches on the thickness of RNFL and GCL.

Keywords: Migraine, optical coherence tomography, retinal nerve fibre layer thickness, ganglion cell layer thickness