The authors present a cross-sectional study which recruited patients with paediatric migraine without aura along with age and sex-matched healthy controls. Both groups were recruited following attendance to an ophthalmology outpatient clinic. Children diagnosed with any of the following were excluded: migraine with aura, an abnormal MRI, refractive error ≥2 dioptres, amblyopia, previous ocular trauma or surgery or other ophthalmological, neurological or systemic disease. All children received a full ophthalmic assessment including visual acuity, fundus and media check, intraocular pressure, central corneal thickness and optical coherence tomography angiography (OCTA). All assessments were performed during a migraine attack-free period. To provide consistency in OCTA capture, it was performed by the same person and within the same hour of the day across all groups to prevent effects of diurnal variation. A total of 23 children were recruited to each group, equating to 46 eyes per group (paediatric migraine vs. control). Age, gender, intraocular pressure and best corrected visual acuity were similar across the groups. The number of eyes with refractive error was significantly higher in the migraine group compared to controls, 46% vs. 9% respectively. There was an almost equal spilt between myopia and hyperopia. Other significant between group differences identified were a thinner central corneal thickness, higher foveal thickness values and lower superficial vessel density values for the paediatric migraine group compared to controls. No correlation was found between OCTA values and time since onset of migraines or attack frequency per year. The authors acknowledge study limitations including small sample size, exclusion of migraine with aura and patients receiving migraine treatment. The authors suggest OCTA could contribute to the diagnosis of paediatric migraine by providing details of structural changes and monitoring progression. Further research is required to assess if OCTA can contribute to identifying increased risk of vascular events in those with a diagnosis of migraine.
