Comparison of ocular posterior segment parameters in the pediatric population with migraine without aura and tension-type headache.

Background: This study aims to compare the posterior ocular structure parameters in children with migraine without aura (MWA), tension-type headache (TTH), and a healthy control group.

Methods: The study included 31 patients with MWA, 29 patients with TTH, and 38 healthy controls between 6 and 18 years of age. For all participants, the detailed eye examination and measurements including peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vessel densities and foveal avascular zone (FAZ) parameters measured by optical coherence tomography (OCT) and OCT-angiography (OCTA), were obtained from the patient files.

Results: The mean age was 12.1±3.3 years in MWA patients, 12.4±2.8 years in TTH patients, and 11.9±3.8 years in the healthy controls (p=0.844). Among the groups, the mean pRNFL thickness, CMT, and SCT values were lowest in the MWA group. However, this difference was not statistically significant (p=0.621, p=0.854 and p=0.201, respectively). The mean and four-quadrant (superior, inferior, temporal, nasal) pRNFL thicknesses, the CMT, and the SCT were not statistically significant between the groups (p=0.621, p=0.500, p=0.186, p=0.565, p=0.744, p=0.854 and p=0.201, respectively). The macular vascular densities were lower in MWA patients than in the other two groups, and there was a statistically significant difference between the groups only in the nasal quadrant of the deep retinal capillary plexus (p = 0.014). There were also no statistically significant differences between the groups in the superficial and deep FAZ area parameters (p=0.652 and p=0.985).

Conclusion: This study suggested that differential diagnosis between MWA and TTH can be difficult in childhood, as these conditions, which can present with ocular symptoms, may also be characterized by changes in posterior segment parameters. Long-term studies incorporating OCT-A in larger patient populations may provide valuable insights into retinal changes associated with these two distinct headache spectrums.