Kawasaki Aki, Udry Morgane, El Wardani Mohamad, Münch Mirjam
Hôpital Ophtalmique Jules Gonin, Fondation Asile des Aveugles, Department of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
Ophthalmology Department, Calderdale and Huddersfield NHS Foundation, Huddersfield, United Kingdom.
Front Neurol. 2021 Jan 15;11:584479. doi: 10.3389/fneur.2020.584479. eCollection 2020.
Glaucoma damages retinal ganglion cells, including intrinsically photosensitive retinal ganglion cells (ipRGCs). These cells modulate various non-visual physiological and psychological functions which are modulated by light. In patients with glaucoma, we assessed the effect of daily bright light exposure (LE) on several melanopsin-dependent functions, such as the pupil constriction, circadian rest-activity cycles, sleep and subjective well-being including relaxation, alertness and mood. Twenty patients participated in the study (9 women, 11 men, mean age = 67.6 ± 7.5 y). Pupillometry was performed before the LE weeks and repeated on the last day of LE. The post-illumination pupil response (PIPR) was calculated as a proxy for melanopsin-dependent activation. Participants continuously wore an activity monitor and self-assessed sleep quality, well-being and visual comfort for 7 days before and during 4 weeks of daily bright LE (30 min to 10,000 lux polychromatic bright white light). After the LE, there was a significantly greater PIPR and higher subjective sleep quality when compared to the pre-LE week ( < 0.05), but no significant changes in 24-h rhythms or sleep parameters. A greater PIPR was correlated with an increase in circadian amplitude and higher inter-daily stability (derived from rest-activity cycles; < 0.05). In a small group of patients with glaucoma, scheduled daily bright light exposure could improve subjective sleep quality. These findings highlight the importance to evaluate and maintain non-visual functions at different levels in patients with progressive loss of ipRGCs.
青光眼会损害视网膜神经节细胞，包括内在光敏性视网膜神经节细胞（ipRGCs）。这些细胞调节各种受光调节的非视觉生理和心理功能。在青光眼患者中，我们评估了每日强光照射（LE）对几种黑素视蛋白依赖性功能的影响，如瞳孔收缩、昼夜休息-活动周期、睡眠以及包括放松、警觉和情绪在内的主观幸福感。20名患者参与了该研究（9名女性，11名男性，平均年龄=67.6±7.5岁）。在LE周之前进行瞳孔测量，并在LE的最后一天重复测量。计算光照后瞳孔反应（PIPR）作为黑素视蛋白依赖激活的指标。参与者在每天30分钟至10000勒克斯多色亮白光的LE为期4周之前和期间，连续7天佩戴活动监测器并自我评估睡眠质量、幸福感和视觉舒适度。与LE前一周相比，LE后PIPR显著更大，主观睡眠质量更高（<0.05），但24小时节律或睡眠参数无显著变化。更大的PIPR与昼夜振幅增加和更高的日间稳定性相关（源自休息-活动周期；<0.05）。在一小群青光眼患者中，定期每日强光照射可改善主观睡眠质量。这些发现凸显了在ipRGCs逐渐丧失的患者中评估和维持不同水平非视觉功能的重要性。
