The Effect of the Menstrual Cycle on the Optic Nerve Head Analysis of Migrainous Women

Abstract

Purpose: To determine the effect of the menstrual cycle on the optic nerve head topographic analysis of normally menstruating migrainous women.Material and Methods: Randomly selected one eye of 44 migrainous and 49 healthy control women with regular menstrual cycles were included in the study. All subjects underwent complete ocular examination. Optic nerve head topographic analysis were performed using a confocal scanning laser ophthalmoscope, HRT II (Heidelberg Retinal Tomograph II, software version 1.6; Heidelberg Engineering, Heidelberg, Germany). They were repeated for two times during the menstrual cycle: in follicular phase (7th to 10th day of the cycle) and in the luteal phase (days 3 to 4 before the menstrual bleeding). Serum estradiol, progesterone, and luteinizing hormone measurements were repeated at each menstrual phase. Results: The mean age of migrainous and control subjects were 31.5 ± 5.1 years and 33.4 ± 3.7 years, respectively (P > 0.05). Their mean disc areas were 2.26 ± 0.46 mm² and 1.95 ± 0.39 mm², respectively (P < 0.05). Control subjects did not demonstrate any difference in the disc topography (P > 0.05). The parameter rim volume decreased, while the parameters cup volume and cup shape measure increased significantly in the luteal phase of the migrainous women (all P values < 0.05). Mean intraocular pressure of the migrainous women decreased significantly in luteal phase (P < 0.05). Conclusion: Significant differences exist in the optic rim and cup parameters during the menstrual cycle of the migrainous women. Further clinical trials on ocular blood flow changes during the menstrual cycle of the migrainous women may highlight the role of sex steroids in the optic nerve head of the migrainous women.

KEYWORDS:

• follicular phase
• luteal phase
• menstrual cycle
• migraine
• optic nerve head topography