ABSTRACT
Parry-Romberg syndrome (PRS), also recognized as progressive hemifacial atrophy (PHA), is a rare medical condition affecting the dermis, subcutaneous tissue, and occasionally underlying anatomical structures such as muscles and bones. While the etiology of this condition remains incompletely elucidated, it has been hypothesized that trauma, autoimmunity, infection, and autonomic dysregulation may constitute potential contributory factors. Typically, the onset of symptoms occurs within the initial two decades of life, though instances of late-onset PRS manifesting in the sixth and seventh decades of life have also been documented. The disorder is distinguished by a gradual progression over two to 20 years, ultimately culminating in stabilization. The local manifestations of PRS are accompanied by systemic symptoms. Common neurological complications include seizures and headaches. Due to the rarity of PRS, there are no established guidelines for imaging, treatment, and follow-up. Therefore, management is tailored to each case, with treatment options primarily addressing symptoms.
ABSTRACT
Background This study aimed to analyze the visual field changes and retinal nerve fiber layer (RNFL) thickness during the headache phase of migraine attacks among migraine patients compared with controls. Methodology A prospective, case-control study was conducted at a tertiary care center in Palakkad, Kerala from January 2022 to August 2023. This study included 50 migraine patients and 50 age/gender-matched controls. Adults aged 20-40 years with a more than three-year history of migraine were included in this study and those who had systemic or ocular pathologies were excluded. All 100 subjects underwent complete ocular examination, including full threshold 24-2 automated perimetry for visual field analysis and optical coherence tomography for analyzing RNFL thickness. Statistical analysis was done using SPSS Statistics Version 25 (IBM Corp., Armonk, NY, USA). Results In this study, the average age for cases was 29.24 ± 5.10 years, and for controls was 30.12 ± 6.20 years. Gender distribution was identical between cases and controls with 29 (58%) females and 21 (42%) males. Among the 50 migraine patients, 22 (44%) had generalized, while 28 (56%) had localized field defects during the headache phase of migraine attacks. There was a statistically significant (p < 0.001) difference in superior quadrant RNFL thickness between cases (114.08 ± 12.25) and controls. Conclusions We found that RNFL thinning in the superior quadrant and non-specific localized visual field changes occur during migraine attacks. We conducted this study in a tertiary care center as very few studies in our country have revealed visual field changes during migraine headache attacks.