Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
NIHR-Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre, King's College Hospital, NIHR, London, UK.
Br J Ophthalmol. 2022 Sep;106(9):1318-1324. doi: 10.1136/bjophthalmol-2020-318653. Epub 2021 Oct 16.
To gather information on useful medications to treat visual snow syndrome (VSS) as well as to validate an instrument to assess its clinical severity and the course of the disorder over time.
Four hundred patients with VSS were included in this web-based prospective questionnaire study. All subjects completed a treatment questionnaire and a clinical diary. The first allowed evaluation of the effects of previous medications on visual snow, while the second measured VSS symptoms daily over the course of 30 days.
Patients commonly reported previous use of medications such as antidepressants, antiepileptics, antibiotics and benzodiazepines. However, none of these drug classes was beneficial for the majority of patients. Recreational drugs and alcohol worsened visual snow symptoms in several reports. Vitamins and benzodiazepines had high therapeutic ratios, although in most cases they did not change the course of VSS.The monthly diary confirmed that the static in VSS is a consistent symptom over time. It also showed that indoor and fluorescent lights have a worse effect on symptoms when compared with natural outdoor lighting.
The study confirms clinical experience that medications are generally ineffective in VSS, with the exception of vitamins and perhaps benzodiazepines, which could be beneficial in some patients. The 30-day diary represents a useful tool to measure symptom progression over time, which could be used in future trials on VSS.
收集有关治疗视觉雪综合征(VSS)的有效药物信息,并验证评估其临床严重程度和疾病随时间变化的过程的工具。
本基于网络的前瞻性问卷调查研究纳入了 400 名 VSS 患者。所有患者均完成了治疗问卷和临床日记。前者用于评估先前药物对视觉雪的影响,后者则在 30 天的过程中每天测量 VSS 症状。
患者通常报告先前使用过抗抑郁药、抗癫痫药、抗生素和苯二氮䓬类药物等药物。然而,这些药物类别对大多数患者并没有益处。在一些报告中,娱乐性药物和酒精会使视觉雪症状恶化。维生素和苯二氮䓬类药物具有较高的治疗比率,尽管在大多数情况下它们并未改变 VSS 的病程。每月日记证实 VSS 中的静态是随时间持续存在的一致症状。它还表明,与自然光相比,室内和荧光灯对症状的影响更差。
该研究证实了临床经验,即除了维生素和可能的苯二氮䓬类药物外,药物通常对 VSS 无效,这些药物可能对某些患者有益。30 天日记是一种有用的工具,可以测量随时间推移的症状进展,可用于未来的 VSS 试验。