Surgical Services, Miami Veterans Administration Medical Center (N.R., J.J.H., A.C., E.V.T.L., R.H., A.G.), Miami, Florida, USA; Bascom Palmer Eye Institute, University of Miami (N.R., J.J.H., A.C., E.V.T.L., A.G.), Miami, Florida, USA.
Brain and Eye Pain Imaging Lab, Pain and Affective Neuroscience Center, Department of Anesthesia (N.P., E.A.M.), Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Massachusetts, USA.
Am J Ophthalmol. 2024 Mar;259:172-184. doi: 10.1016/j.ajo.2023.12.004. Epub 2023 Dec 14.
To assess the therapeutic effect of tinted lenses (FL-41) on photophobia and light-evoked brain activity using functional magnetic resonance imaging (fMRI) in individuals with chronic ocular surface pain.
Prospective case series.
25 subjects from the Miami veterans affairs (VA) eye clinic were recruited based on the presence of chronic ocular pain, dry eye symptoms, and photophobia. Using a 3T MRI scanner, subjects underwent 2 fMRI scans using an event-related design based on light stimuli: one scan while wearing FL-41 lenses and one without. Unpleasantness ratings evoked by the light stimuli were collected after each scan.
With FL-41 lenses, subjects reported decreased (n = 19), maintained (n = 2), or increased (n = 4) light-evoked unpleasantness ratings. Group analysis at baseline (no lens) revealed significant light evoked responses in bilateral primary somatosensory (S1), bilateral secondary somatosensory (S2), bilateral insula, bilateral frontal pole, visual, precuneus, paracingulate, and anterior cingulate cortices (ACC) as well as cerebellar vermis, bilateral cerebellar hemispheric lobule VI, and bilateral cerebellar crus I and II. With FL-41 lenses, light-evoked responses were significantly decreased in bilateral S1, bilateral S2, bilateral insular, right temporal pole, precuneus, ACC, and paracingulate cortices as well as bilateral cerebellar hemispheric lobule VI.
FL-41 lenses modulated photophobia symptoms in some individuals with chronic ocular pain. In conjunction, FL-41 lenses decreased activation in cortical areas involved in processing affective and sensory-discriminative dimensions of pain. Further research into these relationships will advance the ability to provide precision therapy for individuals with ocular pain.
使用功能磁共振成像（fMRI）评估彩色隐形眼镜（FL-41）对慢性眼表疼痛患者畏光和光诱发脑活动的治疗效果。
前瞻性病例系列。
根据慢性眼部疼痛、干眼症症状和畏光的存在，从迈阿密退伍军人事务部（VA）眼科诊所招募了 25 名受试者。使用 3T MRI 扫描仪，受试者进行了 2 次基于光刺激的事件相关 fMRI 扫描：一次扫描时佩戴 FL-41 镜片，一次不佩戴。每次扫描后收集光刺激引起的不适评分。
佩戴 FL-41 镜片时，19 名受试者报告光诱发不适程度降低，2 名受试者保持不变，4 名受试者增加。基线时（无镜片）的组分析显示双侧初级体感（S1）、双侧次级体感（S2）、双侧岛叶、双侧额极、视觉、楔前叶、旁中央回和前扣带回皮质（ACC）以及小脑蚓部、双侧小脑半球 VI 叶和双侧小脑脚 I 和 II 存在显著的光诱发反应。佩戴 FL-41 镜片时，双侧 S1、双侧 S2、双侧岛叶、右侧颞极、楔前叶、ACC 和旁中央回皮质以及双侧小脑半球 VI 叶的光诱发反应显著降低。
FL-41 镜片在一些慢性眼痛患者中调节了畏光症状。同时，FL-41 镜片降低了处理疼痛的情感和感觉辨别维度的皮质区域的激活。对这些关系的进一步研究将提高为眼部疼痛患者提供精准治疗的能力。
