{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:07Z","timestamp":1787028667259,"version":"build-2736575974"},"reference-count":53,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010621","name":"Medical University of Lublin","doi-asserted-by":"crossref","award":["DS 178"],"award-info":[{"award-number":["DS 178"]}],"id":[{"id":"10.13039\/501100010621","id-type":"DOI","asserted-by":"crossref"}]},{"award":["DS 178"],"award-info":[{"award-number":["DS 178"]}],"id":[{"id":"https:\/\/ror.org\/016f61126","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of this study was to assess the macular vasculature and retinal thickness using optical coherence tomography angiography (OCTA) in patients with migraine with aura (MA) and migraine without aura (MO) compared with healthy controls (HCs). Methods: A prospective cohort study included 37 MO patients, 34 MA patients, and 34 HCs. Vessel density (VD) in the superficial and deep retinal plexuses, radial peripapillary capillaries (RPC), optic nerve head (ONH), and foveal avascular zone (FAZ) was measured. The retinal thickness, retinal nerve fiber layer (RNFL) thickness, visual field parameters, and body mass index (BMI) were also evaluated. Results: Significantly lower macular superficial VD in the whole image was observed in the MA group compared with both the MO and HCs. MO patients showed higher RPC VD in the inferior quadrant compared with HCs. No significant differences were found in the RNFL thickness, deep plexus, FAZ area, non-flow area, or visual field parameters. In the MA group, the FAZ area showed a significant inverse correlation with the BMI, and a higher incidence of comorbidities was observed, particularly of Hashimoto\u2019s thyroiditis. Conclusions: These findings suggest that migraine subtypes are associated with distinct retinal microvascular patterns detectable via OCTA. Reduced macular perfusion in MA and increased peripapillary perfusion in MO may reflect subtype-specific vascular dysregulation. OCTA may therefore serve as a noninvasive biomarker for detecting early microvascular alterations in migraine.<\/jats:p>","DOI":"10.3390\/jcm15103853","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:36:40Z","timestamp":1779107800000},"page":"3853","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vascular Changes in the Macula and Peripapillary Regions Using Optical Coherence Tomography Angiography in Migraine with Aura and Migraine Without Aura"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6035-712X","authenticated-orcid":false,"given":"Patrycja","family":"Lesiuk","sequence":"first","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna K.","family":"Szewczyk","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystyna","family":"Mitosek-Szewczyk","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Clinical Hospital No. 4, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Brzozowska","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Medical Biostatistics, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Rejdak","sequence":"additional","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Nowomiejska","sequence":"additional","affiliation":[{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102208","DOI":"10.1016\/j.aprim.2021.102208","article-title":"Migraine Review for General Practice","volume":"54","year":"2022","journal-title":"Aten. Primaria"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/S1474-4422(24)00038-3","article-title":"Global, Regional, and National Burden of Disorders Affecting the Nervous System, 1990\u20132021: A Systematic Analysis for the Global Burden of Disease Study 2021","volume":"23","author":"Steinmetz","year":"2024","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1212\/WNL.58.6.885","article-title":"Migraine in the United States","volume":"58","author":"Lipton","year":"2002","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 328 Diseases and Injuries for 195 Countries, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Vos","year":"2017","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1177\/0333102413485658","article-title":"The International Classification of Headache Disorders, 3rd Edition (Beta Version)","volume":"33","author":"Olesen","year":"2013","journal-title":"Cephalalgia"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/head.14024","article-title":"The Prevalence and Impact of Migraine and Severe Headache in the United States: Updated Age, Sex, and Socioeconomic-specific Estimates from Government Health Surveys","volume":"61","author":"Burch","year":"2021","journal-title":"Headache J. Head Face Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1111\/ene.15778","article-title":"Sex Differences in Clinical Characteristics of Migraine and Its Burden: A Population-Based Study","volume":"30","author":"Chalmer","year":"2023","journal-title":"Eur. J. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/head.14654","article-title":"Reduction in Retinal Microvascular Perfusion during Migraine Attacks","volume":"64","author":"Podraza","year":"2024","journal-title":"Headache J. Head Face Pain"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Liu, Z., Jie, C., Wang, J., Hou, X., Zhang, W., Wang, J., Deng, Y., and Li, Y. (2023). Retina and Microvascular Alterations in Migraine: A Systemic Review and Meta-Analysis. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1241778"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1080\/08164622.2021.1971045","article-title":"The Eye in Migraine: A Review of Retinal Imaging Findings in Migraine","volume":"105","author":"McKendrick","year":"2022","journal-title":"Clin. Exp. Optom."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ajo.2020.11.004","article-title":"Risk of Retinal Artery Occlusion in Patients with Migraine","volume":"225","author":"Tran","year":"2021","journal-title":"Am. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"NP54","DOI":"10.1177\/1120672119899900","article-title":"Vascular Changes with Optical Coherence Tomography Angiography during Aura of Migraine: A Case Report","volume":"31","author":"Atilla","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4024","DOI":"10.1007\/s00415-023-11697-z","article-title":"Microvascular Involvement in Migraine: An Optical Coherence Tomography Angiography Study","volume":"270","author":"Romozzi","year":"2023","journal-title":"J. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3929","DOI":"10.1007\/s10792-021-01962-3","article-title":"Evaluation of Migraine Patients with Optical Coherence Tomography Angiography","volume":"41","author":"Hamurcu","year":"2021","journal-title":"Int. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/opo.12009","article-title":"Statistical Guidelines for the Analysis of Data Obtained from One or Both Eyes","volume":"33","author":"Armstrong","year":"2013","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/head.13300","article-title":"A Phase-by-Phase Review of Migraine Pathophysiology","volume":"58","author":"Dodick","year":"2018","journal-title":"Headache"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1007\/s12264-014-1471-y","article-title":"Role of Cortical Spreading Depression in the Pathophysiology of Migraine","volume":"30","author":"Cui","year":"2014","journal-title":"Neurosci. Bull."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/nrneurol.2012.227","article-title":"The Retina as a Window to the Brain-from Eye Research to CNS Disorders","volume":"9","author":"London","year":"2013","journal-title":"Nat. Rev. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/j.1469-7580.2005.00395.x","article-title":"Retinal Vascular Image Analysis as a Potential Screening Tool for Cerebrovascular Disease: A Rationale Based on Homology between Cerebral and Retinal Microvasculatures","volume":"206","author":"Patton","year":"2005","journal-title":"J. Anat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.preteyeres.2017.01.001","article-title":"Imaging Retina to Study Dementia and Stroke","volume":"57","author":"Cheung","year":"2017","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"100950","DOI":"10.5662\/wjm.v15.i3.100950","article-title":"Evaluation of Macular and Peripapillary Structure and Microvasculature with Optical Coherence Tomography Angiography in Migraine in the Indian Population","volume":"15","author":"Shah","year":"2025","journal-title":"World J. Methodol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jocn.2021.06.045","article-title":"Is Ocular Vascularity Affected in Young Migraine Patients? A Pilot Study","volume":"91","author":"Hamamci","year":"2021","journal-title":"J. Clin. Neurosci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/jcbfm.2010.191","article-title":"Clinical Relevance of Cortical Spreading Depression in Neurological Disorders: Migraine, Malignant Stroke, Subarachnoid and Intracranial Hemorrhage, and Traumatic Brain Injury","volume":"31","author":"Lauritzen","year":"2011","journal-title":"J. Cereb. Blood Flow. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s13760-019-01094-7","article-title":"Retinal Vascular Density Evaluation of Migraine Patients with and without Aura and Association with White Matter Hyperintensities","volume":"119","author":"Ulusoy","year":"2019","journal-title":"Acta Neurol. Belg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5477","DOI":"10.1167\/iovs.17-22477","article-title":"Foveal and Peripapillary Vascular Decrement in Migraine with Aura Demonstrated by Optical Coherence Tomography Angiography","volume":"58","author":"Chang","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_26","first-page":"3412490","article-title":"Altered Macular Vasculature in Migraine Patients without Aura: Is It Associated with Ocular Vasculature and White Matter Hyperintensities?","volume":"2020","author":"Ersoy","year":"2020","journal-title":"J. Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1177\/0333102412451361","article-title":"Migraine and Vascular Diseases: A Review of the Evidence and Potential Implications for Management","volume":"32","author":"Sacco","year":"2012","journal-title":"Cephalalgia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2517","DOI":"10.1007\/s00417-020-04805-6","article-title":"Evaluation of Retinal Vessel Density and Choriocapillaris Flow in Migraine Patients with and without Aura","volume":"258","author":"Atilla","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1080\/01658107.2020.1752260","article-title":"Are Retinal and Peripapillary Blood Flows Affected during Migraine Attack?","volume":"44","author":"Hakkoymaz","year":"2020","journal-title":"Neuroophthalmology"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ke, W., Yu, N., Liu, X., Gu, Y., Qin, Q., Ye, Z., Li, Y., Wang, K., and Chen, M. (2022). Analysis of Macular Microvasculature with Optical Coherence Tomography Angiography for Migraine: A Systematic Review and Meta-Analysis. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.1001304"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/BF00946937","article-title":"Autoregulation of human optic nerve head blood flow in response to acute changes in ocular perfusion pressure","volume":"235","author":"Riva","year":"1997","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1152\/physrev.00034.2015","article-title":"Pathophysiology of Migraine: A Disorder of Sensory Processing","volume":"97","author":"Goadsby","year":"2017","journal-title":"Physiol. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/head.13081","article-title":"The Trigeminovascular Pathway: Role of CGRP and CGRP Receptors in Migraine","volume":"57","author":"Edvinsson","year":"2017","journal-title":"Headache"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1016\/j.jfo.2021.02.018","article-title":"Evaluation of Retinal and Optic Nerve Vasculature by Optic Coherence Tomography Angiography in Migraine with Aura","volume":"44","author":"Karahan","year":"2021","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40662-022-00307-0","article-title":"Age- and Sex-Related Differences in the Retinal Capillary Plexus in Healthy Chinese Adults","volume":"9","author":"Su","year":"2022","journal-title":"Eye Vis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3212","DOI":"10.1167\/iovs.14-16270","article-title":"Macular Perfusion in Healthy Chinese: An Optical Coherence Tomography Angiogram Study","volume":"56","author":"Yu","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3109\/02713683.2014.906625","article-title":"Gender Differences in Ocular Blood Flow","volume":"40","author":"Schmidl","year":"2014","journal-title":"Curr. Eye Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"13878","DOI":"10.1038\/s41598-017-14118-0","article-title":"Investigation of Causes of Sex-Related Differences in Ocular Blood Flow in Healthy Eyes Determined by Laser Speckle Flowgraphy","volume":"7","author":"Iwase","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3109\/01658107.2014.968740","article-title":"Retinal Nerve Fibre Layer Thickness in Migraine Patients with or without Aura","volume":"39","author":"Simsek","year":"2015","journal-title":"Neuro-Ophthalmol."},{"key":"ref_40","first-page":"e2024-0344","article-title":"Optical Coherence Tomography (OCT) and OCT Angiography (OCTA) Findings in Migraine with and without Aura","volume":"89","author":"Jurno","year":"2026","journal-title":"Arq. Bras. Oftalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"814","DOI":"10.3109\/02713683.2015.1056373","article-title":"Retinal Nerve Fiber Layer Thickness Changes in Migraine: A Meta-Analysis of Case-Control Studies","volume":"41","author":"Feng","year":"2016","journal-title":"Curr. Eye Res."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ascaso, F.J., Marco, S., Mateo, J., Mart\u00ednez, M., Esteban, O., and Grzybowski, A. (2017). Optical Coherence Tomography in Patients with Chronic Migraine: Literature Review and Update. Front. Neurol., 8.","DOI":"10.3389\/fneur.2017.00684"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"103515","DOI":"10.1016\/j.pdpdt.2023.103515","article-title":"Associations between Body Mass Index and Choroidal Thickness, Superficial and Deep Retinal Vascular Indices, and Foveal Avascular Zone Measured by OCTA","volume":"42","author":"Ozgur","year":"2023","journal-title":"Photodiagnosis Photodyn. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s00415-003-0975-6","article-title":"Glaucomatous Visual Field Defects in Patients with Migraine","volume":"250","author":"Elhan","year":"2003","journal-title":"J. Neurol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"123","DOI":"10.5455\/medarh.2016.70.123-126","article-title":"Foveal Thickness Alterations in Patients with Migraine","volume":"70","author":"Cankaya","year":"2016","journal-title":"Med. Arch."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"868967","DOI":"10.1155\/2015\/868967","article-title":"The Impact of Migraine on Posterior Ocular Structures","volume":"2015","author":"Demircan","year":"2015","journal-title":"J. Ophthalmol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.sjopt.2014.06.008","article-title":"Correlation of Visual Field Defects and Optical Coherence Tomography Finding in Migraine Patients","volume":"29","author":"Salman","year":"2014","journal-title":"Saudi J. Ophthalmol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/head.14106","article-title":"Prevalence and Association of Lifestyle and Medical-, Psychiatric-, and Pain-related Comorbidities in Patients with Migraine: A Cross-sectional Study","volume":"61","author":"Yin","year":"2021","journal-title":"Headache J. Head Face Pain"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Nowaczewska, M., Straburzy\u0144ski, M., Meder, G., and Waliszewska-Pros\u00f3\u0142, M. (2024). The Relationship between Migraine and Hashimoto\u2019s Thyroiditis: A Single Center Experience. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1370530"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"124","DOI":"10.2174\/1871530317666171124124340","article-title":"Migraine in Systemic Autoimmune Diseases","volume":"18","author":"Cavestro","year":"2018","journal-title":"Endocr. Metab. Immune Disord. Drug Targets"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1038\/s41588-021-00990-0","article-title":"Genome-Wide Analysis of 102,084 Migraine Cases Identifies 123 Risk Loci and Subtype-Specific Risk Alleles","volume":"54","author":"Hautakangas","year":"2022","journal-title":"Nat. Genet."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s10194-019-1017-9","article-title":"Advances in Genetics of Migraine","volume":"20","author":"Sutherland","year":"2019","journal-title":"J. Headache Pain"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Khan, M.H., Lam, A.K.C., Armitage, J.A., Hanna, L., To, C.H., and Gentle, A. (2020). Impact of Axial Eye Size on Retinal Microvasculature Density in the Macular Region. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082539"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3853\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T04:30:46Z","timestamp":1779165046000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3853"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,16]]},"references-count":53,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jcm15103853"],"URL":"https:\/\/doi.org\/10.3390\/jcm15103853","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,16]]}}}