title: Temporal retinal nerve fibre layer thinning in cluster headache patients detected by optical coherence tomography.
abstract: BACKGROUND
  The exact pathophysiology of cluster headache (CH) is still not fully clarified. Various studies confirmed changes in ocular blood flow during CH attacks. Furthermore, vasoconstricting medication influences blood supply to the eye. We investigated the retina of CH patients for structural retinal alterations with optical coherence tomography (OCT), and how these changes correlate to headache characteristics, oxygen use and impaired visual function.
  
  
  METHODS
  Spectral domain OCT of 107 CH patients - 67 episodic, 35 chronic, five former chronic sufferers - were compared to OCT from 65 healthy individuals. Visual function tests with Sloan charts and a substantial ophthalmologic examination were engaged.
  
  
  RESULTS
  Reduction of temporal and temporal-inferior retinal nerve fibre layer (RNFL) thickness was found in both eyes for CH patients with a predominant thinning on the headache side in the temporal-inferior area. Chronic CH patients revealed thinning of the macula compared to episodic suffers and healthy individuals. Bilateral thinning of temporal RNFL was also found in users of 100% oxygen compared to non-users and healthy controls. Visual function did not differ between patients and controls.
  
  
  CONCLUSIONS
  Our OCT findings show a systemic effect causing temporal retinal thinning in both eyes of CH patients possibly due to attack-inherent or medication-induced frequent bilateral vessel diameter changes. The temporal retina with its thinly myelinated parvo-cellular axons and its more susceptible vessels for the vasoconstricting influence of oxygen inhalation seems to be predisposed for tissue damage-causing processes related to CH.
authors: Department of Neurology, University Hospital of Münster, Germany.
authors: Carina
authors: C
authors: Ewering
authors: Department of Neurology, University Hospital of Münster, Germany.
authors: Nazmiye
authors: N
authors: Haşal
authors: Department of Ophthalmology, University Hospital of Münster, Germany.
authors: Florian
authors: F
authors: Alten
authors: Department of Ophthalmology, University Hospital of Münster, Germany.
authors: Christoph R
authors: CR
authors: Clemens
authors: Department of Ophthalmology, University Hospital of Münster, Germany.
authors: Nicole
authors: N
authors: Eter
authors: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Germany.
authors: Timm
authors: T
authors: Oberwahrenbrock
authors: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Germany.
authors: Ella M
authors: EM
authors: Kadas
authors: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Germany.
authors: Hanna
authors: H
authors: Zimmermann
authors: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Germany.
authors: Alexander U
authors: AU
authors: Brandt
authors: Department of Neurology, University Hospital of Münster, Germany.
authors: Nani
authors: N
authors: Osada
authors: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Germany Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Germany.
authors: Friedemann
authors: F
authors: Paul
authors: Department of Neurology, University Hospital of Münster, Germany Department of Neurology, kbo Isar-Amper-Klinikum, München-Ost, Germany Martin.Marziniak@kbo.de.
authors: Martin
authors: M
authors: Marziniak
mesh_terms: D000328:Adult; D003027:Cluster Headache / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D041623:Tomography, Optical Coherence
keywords: Optical coherence tomography; cluster headache; macular thickness; oxygen inhalation; retinal atrophy; retinal nerve fibre layer