Migraine and increased risk of developing open angle glaucoma: a population-based cohort study

Background: Migraine is linked to endothelial dysfunction and is considered to be a systemic vasculopathy. Interestingly, systemic vascular diseases also occur in glaucoma patients and are considered to be vascular risk factors. Whether migraine is simply a concomitant condition in glaucoma patients or a risk factor per se for glaucoma remains unknown. Thus, in the present study, we investigated the risk for open angle glaucoma (OAG) in migraineurs using a 10-year follow-up study that employed a nationwide population-based dataset in Taiwan. Methods: This retrospective matched-cohort study used data sourced from the Longitudinal Health Insurance Database 2000. We included 17,283 subjects with migraine in the study cohort and randomly selected 69,132 subjects from the database for the comparison group. Each subject in this study was individually traced for a 10-year period to identify those subjects who subsequently received a diagnosis of OAG. The age-adjusted Charlson's comorbidity index (ACCI) score was utilized to compute the burden of comorbidity in each subject. Multivariate regression analysis was used to assess risk factors for OAG in migraineurs. Cox proportional hazards regression was performed to compare the 10-year risk of OAG between the migraineurs and the comparison cohort. Results: Migraineurs had more vascular comorbidities than the comparison cohort. The overall incidence of OAG (per 1000 person-years) was 1.29 and 1.02, respectively, for migraineurs and the comparison cohort during the 10-year follow-up period. Age, hyperlipidemia, and diabetes mellitus were three significant risk factors for OAG in migraineurs. After adjusting for patients' age and vascular comorbidities, migraineurs were found to have a 1.68-fold (95% confidence interval [CI], 1.20-2.36) greater risk of developing OAG than the comparison cohort, in subjects with an ACCI score of 0. This association became statistically nonsignificant in subjects with ACCI scores of 1-2 or >= 3. Conclusion: Migraine is associated with a higher risk of OAG for patients with no comorbidity who are aged under 50 years.