Increased risks of retinal vascular occlusion in patients with migraine and the protective effects of migraine treatment: a population-based retrospective cohort study

• Published in: Scientific reports Vol. 14; no. 1; pp. 15429 - 11
• Main Authors: Ho, Kuan-Yun, Lin, Chia-Der, Hsu, Tzu-Ju, Huang, Yu-Han, Tsai, Fuu-Jen, Liang, Chiao-Ying
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 04.07.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/499; 692/617; Adult; Aged; Anti-inflammatory agents; Blindness; Databases, Factual; Epidemiology; Female; Headache; Humanities and Social Sciences; Humans; Incidence; Inflammation; Male; Middle Aged; Migraine; Migraine Disorders - complications; Migraine Disorders - drug therapy; multidisciplinary; Nonsteroidal anti-inflammatory drugs; Occlusion; Population studies; Proportional Hazards Models; Propranolol; Retina; Retinal Artery Occlusion - epidemiology; Retinal vascular occlusion; Retinal Vein Occlusion - complications; Retinal Vein Occlusion - drug therapy; Retinal Vein Occlusion - epidemiology; Retrospective Studies; Risk Factors; Science; Science (multidisciplinary); Taiwan - epidemiology; Vascular occlusion; Young Adult; Taiwan; Retinal vascular occlusion; Epidemiology; Migraine; Blindness
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-66363-9

Associations between migraine and retinal vascular occlusion have been reported, but there is no large-scale and comprehensive study. Therefore, we aimed to determine risks of retinal vascular occlusion in patients with migraine. Using the Taiwan National Health Insurance Research Database from 2009 to 2020, we enrolled 628,760 patients with migraine and 628,760 matched individuals without migraine. Study outcomes were diagnoses of retinal vascular occlusion, including retinal artery occlusion (RAO) and retinal vein occlusion (RVO). Adjusted hazard ratio (aHR) of retinal vascular occlusion related to migraine was estimated. The cumulative incidences of subsequent retinal vascular occlusion, RAO, and RVO were significantly higher in migraine patients compared with controls (0.31% vs. 0.21%; 0.09% vs. 0.05%; 0.22% vs. 0.17%; all p < 0.001). The hazards of retinal vascular occlusion, RAO, and RVO were significantly greater in the migraine group (aHR, 1.69 [95% CI, 1.57, 1.83], 2.13 [95% CI, 1.84, 2.48] and 1.53 [95% CI, 1.40, 1.68], respectively). Risks of retinal vascular occlusion were significantly higher in migraine both with aura (MA) and without aura (MO) (aHR, 1.77 [95% CI, 1.58, 1.98], and 1.92 [95% CI, 1.64, 2.25]). Among patients with migraine, nonsteroidal anti-inflammatory drugs, propranolol, and flunarizine significantly reduce their risks of retinal vascular occlusion (aHR, 0.19 [95% CI, 0.16, 0.22], 0.73 [95% CI, 0.62, 0.86], 0.84 [95% CI, 0.76, 0.93]). Migraine, MA and MO are independently associated with higher risks of retinal vascular occlusion, RAO, and RVO.