Background: To explore the role of microvascular pathology in migraine, we investigated the association between migraine and retinal microvascular damage. Methods: We included 3270 participants (age ≥ 45 years, 63% women) from the population-based Rotterdam Study (2006–2009). Participants with migraine were identified using a validated questionnaire based on ICHD-II criteria (n = 562). Retinopathy signs were graded on fundus photographs. Retinal arteriolar and venular caliber were measured by semi-automatic assessment of fundus photographs. Associations of migraine with retinopathy and retinal microvascular calibers were examined using logistic and linear regression models, respectively, adjusting for age, sex, and cardiovascular risk factors. Results: Migraine was not associated with the presence of retinopathy (odds ratio (OR): 1.09, 95% confidence interval (CI) 0.62; 1.92). In the fully adjusted model, adjusting for the companion vessel, persons with migraine did not differ in retinal arteriolar or venular caliber compared to persons without migraine (mean difference in standardized arteriolar caliber −0.05 (95%CI −0.13; 0.03); in standardized venular caliber −0.00 (95%CI −0.09; 0.08)). Migraine subtypes, including migraine with aura, were also not associated with retinal microvascular damage. Conclusions: Our findings suggest that migraine is not associated with retinopathy or difference in retinal microvascular caliber. Further studies are needed to confirm these results.

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Keywords cohort studies, Epidemiology, headache, microvascular disease, retinal microvascular caliber, retinopathy
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Journal Cephalalgia: an international journal of headache
Wen, K.-X, Mutlu, U, Ikram, M.K, Kavousi, M, Klaver, C.C.W, Tiemeier, H.W, … Ikram, M.K. (2018). The retinal microcirculation in migraine: The Rotterdam Study. Cephalalgia: an international journal of headache, 38(4), 736–743. doi:10.1177/0333102417708774