BACKGROUND: Pattern-induced visual discomfort and photophobia are frequently observed symptoms in migraineurs. The presumed pathophysiologic mechanisms of pattern glare and photophobia seem to overlap anatomically within the central nervous system. OBJECTIVE: To assess the relationship between interictal pattern-induced visual discomfort and ictal photophobia in episodic migraineurs. METHODS: We compared pattern-induced visual discomfort among 3 groups: controls, migraineurs without ictal photophobia (MwoP), and migraineurs with ictal photophobia (MwP). Photophobia was assessed with a validated photophobia questionnaire. Visual discomfort tests were performed using 3 striped patterns with different spatial frequencies. After viewing the patterns for 10 seconds, subjects were asked to report the severity of visual discomfort using 4 scales (none, mild, moderate, and severe) and using a 0-10 visual analog scale (VAS). We compared the proportion of subjects choosing moderate-to-severe discomfort and the median values of VAS scores for each pattern among the 3 groups. RESULTS: We enrolled 35 controls, 18 MwoP, and 44 MwP, and there were no significant differences in clinical features among the 3 groups. MwP reported a significantly higher proportion of moderate-to-severe discomfort and higher median VAS scores than the controls and MwoP did. The intensity of discomfort increased with higher frequency of visual stimuli. CONCLUSIONS: We conclude that MwP experienced more severe pattern-induced visual discomfort as compared with the controls and MwoP.
BACKGROUND: Pattern-induced visual discomfort and photophobia are frequently observed symptoms in migraineurs. The presumed pathophysiologic mechanisms of pattern glare and photophobia seem to overlap anatomically within the central nervous system. OBJECTIVE: To assess the relationship between interictal pattern-induced visual discomfort and ictal photophobia in episodic migraineurs. METHODS: We compared pattern-induced visual discomfort among 3 groups: controls, migraineurs without ictal photophobia (MwoP), and migraineurs with ictal photophobia (MwP). Photophobia was assessed with a validated photophobia questionnaire. Visual discomfort tests were performed using 3 striped patterns with different spatial frequencies. After viewing the patterns for 10 seconds, subjects were asked to report the severity of visual discomfort using 4 scales (none, mild, moderate, and severe) and using a 0-10 visual analog scale (VAS). We compared the proportion of subjects choosing moderate-to-severe discomfort and the median values of VAS scores for each pattern among the 3 groups. RESULTS: We enrolled 35 controls, 18 MwoP, and 44 MwP, and there were no significant differences in clinical features among the 3 groups. MwP reported a significantly higher proportion of moderate-to-severe discomfort and higher median VAS scores than the controls and MwoP did. The intensity of discomfort increased with higher frequency of visual stimuli. CONCLUSIONS: We conclude that MwP experienced more severe pattern-induced visual discomfort as compared with the controls and MwoP.
Authors: Jennifer D Verriotto; Alex Gonzalez; Mariela C Aguilar; Jean-Marie A Parel; William J Feuer; Andrew R Smith; Byron L Lam Journal: Transl Vis Sci Technol Date: 2017-08-15 Impact factor: 3.283