Dry eye symptoms are associated with a significant reduction
in visual quality of life in patients with migraine, according to study results
published in Headache.
Results from previous clinical studies have shown that photophobia, aura, dry eye, or a combination of these symptoms are most likely to contribute to a reduction in visual quality of life in patients with migraine. The quality of life instruments used in these studies measured several different dimensions; therefore, researchers have been unable to determine which ocular symptoms contribute to reduced visual quality of life. The objective of this study was to identify the ocular symptoms driving the reduction in visual quality of life in patients with migraine.
In this cross-sectional, survey-based study, researchers
recruited patients with migraine from the Headache and General Neurology
clinics at the University of Utah Health Sciences Center. Patients completed 5
validated questionnaires: The National Eye Institute visual function
questionnaire (VFQ-25), the headache impact test (HIT-6), the visual aura
rating scale (VARS), the ocular surface disease index (OSDI), and the Utah
photophobia symptom impact scale (UPSIS-17).
Patients were characterized as having migraine with aura,
migraine without aura, episodic migraine, and/or chronic migraine. Associations
between VFQ-25 and OSDI, VFQ-25 and VARS, VFQ-25 and UPSIS-17, HIT-6 and OSDI,
HIT-6 and VARS, and HIT-6 and UPSIS-17 were calculated using Pearson’s
correlation coefficients with P values, and a simple linear regression model
was used to examine the relationship between VFQ-25, OSDI, VARS, and USPIS-17.
Results revealed that of the patients who completed all
questionnaires (n=62), 17 had episodic migraine, 45 had chronic migraine, 23
had migraine with aura, and 39 had migraine without aura. The strongest
correlation observed was between VFQ-25 and OSDI (−0.678; P <.001); this correlation
remained with the inclusion of patient subpopulations. Significant correlations
were observed between HIT-6 and OSDI (0.453; P <.001), and between HIT-6 and UPSIS-17 (0.489; P <.001). Simple linear
regression model only found a significant relationship between VFQ-25 and OSDI.
Factors which may have limited these findings include
similarities between the OSDI and VFQ-25 questionnaire and the small number of
individuals in the migraine group. Moreover, the focus on patients in a
tertiary hospital may limit the ability to generalize these results to other
Researchers concluded that “although photophobia and
aura negatively affect visual quality of life, dry eye symptoms appear to be
the strongest driver of poor visual quality of life.” They add that the
correlation between photophobia and headache “lends support to our
previous finding that treating photophobia can positively influence headache
authors declared possible conflicts of interest. Please see the original
reference for a full list of authors’ disclosures.
Ozudogru S, Neufeld A, Katz BJ, et al. Reduced visual quality of life associated with migraine is most closely correlated with symptoms of dry eye [published online September 26, 2019]. Headache. doi:10.1111/head.13662