University of Miami Miller School of Medicine, Miami, FL, USA.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Expert Opin Ther Targets. 2022 Aug;26(8):681-695. doi: 10.1080/14728222.2022.2122438. Epub 2022 Sep 20.
Dysfunction at various levels of the somatosensory system can lead to ocular surface pain with a neuropathic component. Compared to nociceptive pain (due to noxious stimuli at the ocular surface), neuropathic pain tends to be chronic and refractory to therapies, making it an important source of morbidity in the population. An understanding of the options available for neuropathic ocular surface pain, including new and emerging therapies, is thus an important topic.
This review will examine studies focusing on ocular surface pain, emphasizing those examining patients with a neuropathic component. Attention will be placed toward recent (after 2017) studies that have examined new and emerging therapies for neuropathic ocular surface pain.
Several therapies have been studied thus far, and continued research is needed to identify which individuals would benefit from specific therapies. Gaps in our understanding exist, especially with availability of in-clinic diagnostics for neuropathic pain. A focus on improving diagnostic capabilities and researching gene-modulating therapies could help us to provide more specific mechanism-based therapies for patients. In the meantime, continuing to uncover new modalities and examining which are likely to work depending on pain phenotype remains an important short-term goal.
感觉系统各级功能障碍可导致伴有神经病理性成分的眼表疼痛。与伤害性疼痛(由眼表的有害刺激引起)相比,神经病理性疼痛往往是慢性的,且对治疗有抗性,这使其成为人群发病率的一个重要来源。因此,了解可供选择的治疗神经病理性眼表疼痛的方法,包括新出现的治疗方法,是一个重要的课题。
本篇综述将检查着眼于眼表疼痛的研究,重点关注那些检查有神经病理性成分的患者的研究。将关注最近(2017 年后)研究中针对神经病理性眼表疼痛的新出现的治疗方法。
迄今为止,已经研究了几种治疗方法,需要继续研究以确定哪些个体将从特定治疗中受益。我们的理解存在差距,特别是在神经病理性疼痛的临床诊断方面。关注改善诊断能力和研究基因调节疗法,可以帮助我们为患者提供更具针对性的基于机制的治疗方法。同时,继续发现新的治疗方法,并根据疼痛表型来检查哪些方法可能有效,仍是一个重要的短期目标。