Patients With Migraine Have Substantial Reductions in Measures of Visual Quality of Life
Objective Migraine is associated with several important visual symptoms, during both acute attacks and headache‐free intervals. The purpose of this investigation was to use validated vision‐related quality of life instruments to assess the effect of migraine on visual quality of life. Background Man...
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| Published in: | Headache Vol. 58; no. 7; pp. 1007 - 1013 |
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| Main Authors: | , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Wiley Subscription Services, Inc
01-07-2018
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Objective
Migraine is associated with several important visual symptoms, during both acute attacks and headache‐free intervals. The purpose of this investigation was to use validated vision‐related quality of life instruments to assess the effect of migraine on visual quality of life.
Background
Many migraineurs experience visual aura, increased photophobia during and between headache attacks, and increased symptoms of dry eye with structural changes in corneal nerve endings. Other visual symptoms associated with migraine include positive persistent visual phenomenon (visual snow) and transient vision changes. Previous research looking at the disability associated with migraine has shown that patient‐reported quality of life data can be useful in determining the severity of disease burden. Recent published literature has suggested that visual symptoms related to migraine represent a proportionally minor burden to patients, compared to other manifestations of migraine, but no previous studies have assessed how migraine affects visual quality of life.
Methods
In this cross‐sectional quantitative survey, visual quality of life in individuals with chronic and episodic migraine was assessed using the National Eye Institute Visual Function Questionnaire‐25, and the 10‐item National Eye Institute Visual Function Questionnaire‐25 Neuro‐Ophthalmic Supplement. Overall headache severity and impact was assessed using the Migraine‐specific Quality of Life Questionnaire (Version 2.1) and the Headache Impact Test‐6. Participants were recruited from Headache and Neuro‐ophthalmology subspecialty clinics. The target sample size was 30 participants per subgroup. The results were compared to those from disease‐free controls and to results from other neuro‐ophthalmic disease quality of life studies.
Results
Among 29 participants with chronic migraine, vision‐specific quality of life scores were all statistically significantly decreased compared to disease‐free controls. The National Eye Institute Visual Function Questionnaire‐25 median composite score was 85 for chronic migraineurs and 96 for controls (P < .001). The 10‐item National Eye Institute Visual Function Questionnaire‐25 Neuro‐Ophthalmic Supplement median score was 72 for chronic migraineurs and 95 for controls (P < .001). Among 37 participants with episodic migraine, vision‐specific quality of life scores were also decreased compared to disease‐free controls. In the episodic migraine group, decreases in the National Eye Institute Visual Function Questionnaire‐25 scores were not statistically significant (median score 91, P = .01 compared to the control group), but decreases in the 10‐item National Eye Institute Visual Function Questionnaire‐25 Neuro‐Ophthalmic Supplement remained statistically significant (median score 85, P = .003 compared to the control group). Chronic migraineurs had decreased visual quality of life scores compared to those with episodic migraines. Participants with chronic migraine had visual quality of life scores that were as poor as those previously published for patients with other neuro‐ophthalmic disorders such as multiple sclerosis, myasthenia gravis, and ischemic optic neuropathy.
Conclusions
Visual quality of life is significantly adversely affected in migraine sufferers. In fact, patients with chronic migraine may have visual quality of life impacts that are as significant as those associated with other common neuro‐ophthalmic disorders. Future studies of the overall disease burden in patients with migraine should include an evaluation of the effects on visual functioning. |
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| Bibliography: | Financial Support Presented in abstract form at the 43rd Annual Meeting of the North American Neuro‐Ophthalmology Society, Washington, DC, April 1‐6, 2017. Conflict of Interest Correction added on July 5, 2018, after first online publication: Author name “Pippett” changed to “Pippitt.” This study was supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, NY, USA to the Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA. BJK and KBD are named on a patent that describes the use of optical filters to treat light sensitivity; BJK is the CEO of Axon Optics, LLC, an online company that sells eyewear for the treatment of light sensitivity. To manage this conflict of interest, both authors were recused from interviewing patients, collecting data, or analyzing the data. The other authors have no conflicts of interest. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0017-8748 1526-4610 |
| DOI: | 10.1111/head.13330 |