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Ophthalmology 1997-Oct

Is there an association between migraine headache and open-angle glaucoma? Findings from the Blue Mountains Eye Study.

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J J Wang
P Mitchell
W Smith

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OBJECTIVE

To determine whether an association exists between migraine headache history and open-angle glaucoma (OAG).

METHODS

Population-based, cross-sectional study.

METHODS

Subjects were 3654 people aged 49 or older; 82% of permanent residents from an area west of Sydney participated.

METHODS

All participants underwent an interview and a detailed eye examination, including automated perimetry and stereo optic disc photography.

METHODS

Open-angle glaucoma was diagnosed in subjects with matching typical glaucomatous visual field defects and pathologic optic disc cupping, independent of intraocular pressure level. The diagnosis of migraine history (typical or nontypical) was based on participant responses to specific questions, consistent with International Headache Society criteria.

RESULTS

Open-angle glaucoma prevalence increased exponentially with age, with rates of 0.4%, 1.3%, 4.7%, and 11.4% among persons aged less than 60 years, between 60 and 69 years, between 70 and 79 years, and 80 years or older, respectively. The frequency of reporting a past history of typical migraine headache declined with increasing age, with rates of 23.1%, 16.2%, 12.8%, and 10.4% for corresponding age groups. For all age groups combined, there was no significant association between typical migraine headache and OAG (odds ratio [OR], 1.3; 95% confidence interval [CI], 0.8-2.2), after multivariate adjustment. However, after stratifying into 10-year age groups, increased odds for OAG were found for people giving a history of typical migraine headache and aged 70-79 years (OR, 2.5; 95% CI 1.2-5.2), after adjusting for variables found associated with glaucoma. This association was marginally stronger for high-pressure OAG cases (OR, 2.7; 95% CI, 1.1-5.6).

CONCLUSIONS

These data suggest the possibility of an association between history of typical migraine headache and OAG, which could be modified by age.

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