Quantitative Assessment of Subjective Symptoms and Corneal Sensitivity in Chronic Orbital Pain Patients.
Quantitative Assessment of Subjective Symptoms and Corneal Sensitivity in Chronic Orbital Pain Patients.
复制标题
慢性眼眶疼痛患者主观症状和角膜敏感性的定量评估。
DOI：
10.1097/iop.0000000000002515
复制
发表时间：
2024
影响因子：
2
通讯作者：
Shriver,ErinM
中科院分区：
文献类型：
--
作者：
Lee,Grace;Kardon,RandyH;Nellis,JulieK;Pham,ChauM;Sales,ChristopherS;Carter,KeithD;Shriver,ErinM
目的：客观评价慢性眼眶痛的主观症状和特点，量化三叉外周神经的致敏性。方法：在这项前瞻性队列研究中，先前对三叉外周神经阻滞治疗单侧特发性慢性眼眶疼痛有反应的患者和健康受试者完成了有效的问卷调查，评估头痛、神经性体征和症状、畏光和疼痛质量。用Cochet-Bonnet美感计测量所有受试者双眼的角膜敏感度。对于疼痛患者，在研究注射后2-4周重复完整的评估方案，并在注射后30分钟测量角膜敏感性。评估结果为头痛、神经性疼痛和畏光评分；痛苦的品质;还有角膜敏感度。结果：纳入6例女性慢性眶痛患者（平均年龄48.2岁）和11例女性对照组（平均年龄47.5岁）。疼痛患者的平均头痛、神经性疼痛和畏光问卷得分显著高于对照组（p< 0.001）。在感觉测试中，5例疼痛患者（83.3%）表现为异常性痛觉，6例患者（100%）均表现为同侧额神经皮节痛觉过敏。对照组没有异常性痛觉或痛觉过敏。疼痛患者和组间的角膜敏感性相似。注射后问卷评分和角膜敏感性无明显变化。结论：慢性眼窝疼痛患者由于头痛和畏光导致生活质量明显下降。眶上神经和滑车上神经被致敏，导致相应皮节的皮肤过敏，但角膜神经具有正常的敏感性。
Purpose:To objectively evaluate the subjective symptoms and characteristics of chronic orbital pain as well as to quantify sensitization of peripheral trigeminal nerves.Methods:In this prospective cohort study, patients who previously showed a response to peripheral trigeminal nerve blocks for unilateral, idiopathic chronic orbital pain and healthy subjects completed validated questionnaires assessing headaches, neuropathic signs and symptoms, photophobia, and pain qualities. Corneal sensitivity was measured in both eyes for all subjects with a Cochet-Bonnet aesthesiometer. For pain patients, the full assessment protocol was repeated 2–4 weeks after the study injection, and corneal sensitivity was also measured 30 minutes postinjection. Outcomes assessed were headache, neuropathic pain, and photophobia scores; pain qualities; and corneal sensitivity.Results:Six female chronic orbital pain patients (mean age 48.2 years) and 11 female controls (mean age 47.5) were included. The mean headache, neuropathic pain, and photophobia questionnaire scores were significantly higher for pain patients than for controls (p< 0.001). On sensory testing, 5 pain patients (83.3%) endorsed allodynia, and all 6 (100%) had hyperalgesia in the ipsilateral frontal nerve dermatome. No controls had allodynia or hyperalgesia. Corneal sensitivity was similar between eyes in pain patients and between groups. Questionnaire scores and corneal sensitivity did not change significantly after the injection.Conclusions:Chronic orbital pain patients have a measurable reduction in quality of life due to headaches and photophobia. The supraorbital and supratrochlear nerves are sensitized, resulting in cutaneous hypersensitivity in the corresponding dermatome, but corneal nerves have normal sensitivity.