title: The effect of cigarette smoking on retinal nerve fiber layer thickness in patients with migraine.
abstract: BACKGROUND
  Migraine is a frequent and disabling chronic neurological condition with complex pathophysiology. Both cigarette smoking and migraine may cause damage to the optic nerve.
  
  
  OBJECTIVE
  The primary objective of this study was to investigate the effect of cigarette smoking on retinal nerve fiber layer (RNFL) thickness in patients with migraine.
  
  
  METHODS
  Eighty-four consecutive patients diagnosed with migraine (34 smokers and 50 nonsmokers) and 66 age- and gender-matched healthy non-smoker controls were enrolled for this observational cross-sectional study. RNFL thickness was measured using spectral-domain optical coherence tomography (OCT) and then RNFL thickness in patients with migraine who smoke was compared to nonsmoking patients with migraine and healthy subjects.
  
  
  RESULTS
  The average, superior, nasal and inferior RNFL thicknesses were significantly thinner in patients with migraine compared to the control group (p < 0.001, p = 0.02, p < 0.001 and p = 0.04, respectively). The average and inferior RNFL thicknesses were significantly reduced in smoker patients with migraine compared to the nonsmokers (p = 0.011, p = 0.045, respectively). Nonsmoker patients with migraine had significantly thinner average and nasal RNFL thicknesses than the control group (p = 0.001, p = 0.001, respectively).
  
  
  CONCLUSIONS
  Cigarette smoking may cause significant RNFL thinning in patients with migraine. OCT may be a feasible technique for determination of smoking-induced ocular damage in patients with migraine.
authors.affiliation: a Department of Neurology and.
authors.forename: Seden
authors.initials: S
authors.lastname: Demirci
authors.affiliation: b Department of Ophthalmology , School of Medicine, Süleyman Demirel University , Isparta , Turkey.
authors.forename: Alime
authors.initials: A
authors.lastname: Gunes
authors.affiliation: a Department of Neurology and.
authors.forename: Serpil
authors.initials: S
authors.lastname: Demirci
authors.affiliation: a Department of Neurology and.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Kutluhan
authors.affiliation: b Department of Ophthalmology , School of Medicine, Süleyman Demirel University , Isparta , Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Tok
authors.affiliation: b Department of Ophthalmology , School of Medicine, Süleyman Demirel University , Isparta , Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Tok
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000473:pathology*; D009412:Nerve Fibers / Q000187:drug effects* / Q000473:pathology; D012160:Retina / Q000187:drug effects* / Q000473:pathology; D012907:Smoking / Q000009:adverse effects*; D041623:Tomography, Optical Coherence
keywords: Migraine; retinal nerve fiber layer thickness; smoking