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1 From the Discoveries in Sight, Devers Eye Institute, Legacy Clinical Research and Technology Center, Portland, Oregon; 2 Department of Optometry and Vision Sciences, University of Melbourne, Carlton, Australia; 3 Department of Psychology, University of Western Australia, Perth; and 4 Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.
PURPOSE. To characterize the visual fields of subjects with migraine headaches using static and temporal modulation perimetry.
METHODS. Sixteen subjects with migraines (15 with aura, 1 without) and 15 nonheadache controls were tested. Perimetry was conducted 7 days after the offset of a headache with both static and temporally modulated targets using the Medmont M-600 automated perimeter (Medmont Pty Ltd., Camberwell, Victoria, Australia). Flicker thresholds were measured using the autoflicker test, which varies flicker rate with eccentricity. A subset of four subjects with migraines (3 with aura, 1 without) had the temporal tuning characteristics of their loss evaluated using fixed temporal frequencies (4, 6, 9, 12, and 16 Hz).
RESULTS. Field losses were identified with temporal modulation perimetry in 11
of 16 migraine subjects. The majority of these losses occurred in the
presence of normal static thresholds (8/11). The deficits displayed
temporal tuning, being greatest for higher temporal frequencies (
9
Hz). None of the subjects revealed deficits typical of cortical
lesions. The migraine-without-aura subject displayed a
selective loss to temporally modulated stimuli, which was consistent
with the aura group. This defect altered over time, decreasing for 30
to 40 days but remaining, to a smaller extent, for up to 75 days after
the headache event.
CONCLUSIONS. Visual dysfunction that is selective for temporally modulated targets occurs in migraine subjects. The migrainous pattern of dysfunction shares some features with that identified in early stages of glaucoma and raises the possibility for a common precortical vascular involvement in these two conditions.
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