Brouwer A, Nguyen H-T, Snoek F J, van Raalte D H, Beekman A T F, Moll A C, Bremmer M A
Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands.
Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands.
Acta Psychiatr Scand. 2017 Dec;136(6):534-548. doi: 10.1111/acps.12785. Epub 2017 Sep 10.
Light therapy has become an increasingly popular treatment for depression and a range of other neuropsychiatric conditions. Yet, concerns have been raised about the ocular safety of light therapy.
We conducted the first systematic review into the ocular safety of light therapy. A PubMed search on January 4, 2017, identified 6708 articles, of which 161 were full-text reviewed. In total, 43 articles reporting on ocular complaints and ocular examinations were included in the analyses.
Ocular complaints, including ocular discomfort and vision problems, were reported in about 0% to 45% of the participants of studies involving light therapy. Based on individual studies, no evident relationship between the occurrence of complaints and light therapy dose was found. There was no evidence for ocular damage due to light therapy, with the exception of one case report that documented the development of a maculopathy in a person treated with the photosensitizing antidepressant clomipramine.
Results suggest that light therapy is safe for the eyes in physically healthy, unmedicated persons. The ocular safety of light therapy in persons with preexisting ocular abnormalities or increased photosensitivity warrants further study. However, theoretical considerations do not substantiate stringent ocular safety-related contraindications for light therapy.
光疗法已成为治疗抑郁症及一系列其他神经精神疾病越来越常用的方法。然而,人们对光疗法的眼部安全性提出了担忧。
我们对光疗法的眼部安全性进行了首次系统评价。2017年1月4日在PubMed上进行检索,共识别出6708篇文章,其中161篇进行了全文审阅。分析共纳入43篇报告眼部不适及眼部检查情况的文章。
在接受光疗法的研究参与者中,约0%至45%报告了眼部不适,包括眼部不适和视力问题。基于个别研究,未发现不适的发生与光疗法剂量之间存在明显关联。除一份病例报告记录了使用光敏性抗抑郁药氯米帕明治疗的患者发生黄斑病变外,没有证据表明光疗法会导致眼部损伤。
结果表明,对于身体健康、未用药的人来说,光疗法对眼睛是安全的。光疗法在已有眼部异常或光敏性增加的人群中的眼部安全性值得进一步研究。然而,从理论上考虑,并没有确凿证据支持与眼部安全相关的严格光疗法禁忌症。