Hatice Tuba ATALAY, Şule BİLEN, Sedef KUTLUK, Gülcan KURAL

Migren Kliniğinde Optometrik Bulguların Önemi

Giriş: Migren, saatler ya da günler sürebilen, zonklayıcı karakterli, bulantı,kusma, ışık ve ses hassasiyetinin eşlik ettiği bir baş ağrısıdır. Migren ile kırmakusurları ve binoküler görme anomalileri arasında bir ilişki bulunduğuna dairiddialar bulunmaktadır. Bu çalışmada, migren tanısı almış hastalardaoptometrik ve ortoptik bulguları incelemeyi ve sağlıklı bireylerle kıyaslamayıamaçladık.Yöntem: Çalışmamıza, 58 migren hastası ve 50 sağlıklı kontrol dahil edildi.Hastalar, astenopik şikayetler, fotofobi ve görsel semptomlar açısındansorgulandı. Hastaların; sferik kırma kusuru, astigmatik kırma kusuru, sferikeşdeğer, düzeltilmiş en iyi görme keskinliği, ön segment ve fundus muayenesi,motilite muayenesi, füzyon aralıkları ve stereopsis ölçümleri kaydedildi.Bulgular: Migren hastalarında miyopik ve astigmatizmatik kırma kusuru dahafazla izlendi, yakın füzyonel konverjans amplütüdleri ise daha düşük izlendi(sırasıyla p=0.020, p=0.019, p=0.00).Sonuç: Kırma kusuru varlığı ve füzyon mekanizmalarının yetersizliği migrenkliniğine olumsuz katkı sağlıyor olabilir. Bu nedenle, migren hastalarınauygulanacak düzenli göz muayeneleri ile mevcut kırma kusurları ve ortoptikanomaliler saptanmalı ve tedavi edilmelidir.

The Optometric Correlates of Migraine

Objective: Migraine is one of the most common debilitating diseases characterized by pulsating headaches continued from a few hours to several days, accompanied by nausea, vomiting, sensitivity to light and sound. There have been claims of a relationship between migraine headaches and refractive errors and binocular vision anomalies. In this study, we aimed to evaluate optometric and ortoptic findings in patients with migraine headache and to compare with healthy subjects. Methods: This study includes 58 patients with migraine and 50 healthy subjects. Asthenopic symptoms, fotofobia, and visual symptoms of the patients were noted. Detailed ophthalmological examinations were performed containing spherical refractive error, astigmatic refractive error, spherical equivalent (SE), best-corrected visual acuity, slit lamp biomicroscopy, fundus examination. Also, ortoptic examination was performed icluding ocular motility, fusional reserves, and stereopis measurements. Results: Myopia and astigmatism were more frequent in migraine patients and near fusional convergence amlitudes were lower when compared with the control subjects (p=0.020, p=0.019, p=0.00 respectively). Conclusion: This study suggests that refractive errors and insufficiency of fusional mechanisms may make a negative contribution to migraine headache. Therefore, people who experience migraine headaches should have opthalmological examinations regularly to ensure that their refractive errors and ortoptic abnormalities are appropriately managed.

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