Mathis Thibaud, Vignot Stephane, Leal Cecila, Caujolle Jean-Pierre, Maschi Celia, Mauget-Faÿsse Martine, Kodjikian Laurent, Baillif Stéphanie, Herault Joel, Thariat Juliette
Department of Ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France.
Department of Medical Oncology, Jean Godinot Institute, 51100 Reims, France.
Oncotarget. 2017 Jun 28;8(38):64579-64590. doi: 10.18632/oncotarget.18719. eCollection 2017 Sep 8.
Anomalous visual perceptions have been reported in various diseases of the retina and visual pathways or can be experienced under specific conditions in healthy individuals. Phosphenes are perceptions of light in the absence of ambient light, occurring independently of the physiological and classical photonic stimulation of the retina. They are a frequent symptom in patients irradiated in the region of the central nervous system (CNS), head and neck and the eyes. Phosphenes have historically been attributed to complex physical phenomena such as Cherenkov radiation. While phosphenes are related to Cherenkov radiation under high energy photon/electron irradiation conditions, physical phenomena are unlikely to be responsible for light flashes at energies used for ocular proton therapy. Phosphenes may involve a direct role for ocular photoreceptors and possible interactions between cones and rods. Other mechanisms involving the retinal ganglion cells or ultraweak biophoton emission and rhodopsin bleaching after exposure to free radicals are also likely to be involved. Despite their frequency as shown in our preliminary observations, phosphenes have been underreported probably because their mechanism and impact are poorly understood. Recently, phosphenes have been used to restore the vision and whether they might predict vision loss after therapeutic irradiation is a current field of investigation. We have reviewed and also investigated here the mechanisms related to the occurrence of phosphenes in irradiated patients and especially in patients irradiated by proton therapy for ocular tumors.
在视网膜和视觉通路的各种疾病中均有异常视觉感知的报道，或者在健康个体的特定条件下也可能出现。光幻视是在没有环境光的情况下对光的感知，其发生独立于视网膜的生理和经典光子刺激。它们是中枢神经系统（CNS）、头部和颈部以及眼睛区域接受辐射的患者的常见症状。从历史上看，光幻视被归因于诸如切伦科夫辐射等复杂的物理现象。虽然在高能光子/电子辐照条件下光幻视与切伦科夫辐射有关，但物理现象不太可能是眼部质子治疗所用能量下闪光的原因。光幻视可能涉及眼部光感受器的直接作用以及视锥细胞和视杆细胞之间可能的相互作用。其他涉及视网膜神经节细胞或超弱生物光子发射以及暴露于自由基后视紫红质漂白的机制也可能参与其中。尽管如我们初步观察所示光幻视很常见，但可能由于对其机制和影响了解不足，一直未得到充分报道。最近，光幻视已被用于恢复视力，以及它们是否可以预测治疗性辐照后的视力丧失是当前的一个研究领域。我们在此回顾并研究了与接受辐照的患者，特别是接受眼部肿瘤质子治疗的患者中光幻视发生相关的机制。
