Neural mechanisms underlying photophobia and dry eye

畏光和干眼症的神经机制

• 批准号: 9885368
• 负责人: Anat Galor
• 金额: --
• 依托单位: MIAMI VA HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9885368
• 关键词: Ache; Activities of Daily Living; Acute; Address; Affect; Aftercare; Age; Algorithms; Automobile Driving; Bilateral; Botulinum Toxins; Cell Nucleus; Chronic; Computers; Control Groups; Cornea; Cutaneous; Darkness; Data; Diagnosis; Disease; Distress; Dryness; Esthesia; Event; Eye; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Home environment; Image; Individual; Injections; Intrinsic drive; Knowledge; Light; Measures; Medial; Morbidity - disease rate; Nerve; Nerve Block; Neural Pathways; Neuraxis; Neuronal Plasticity; Nociception; Pain; Pain Measurement; Participant; Pathologic; Pathway interactions; Patients; Peripheral; Photophobia; Photosensitivity; Physical Function; Population; Positioning Attribute; Prisoner; Process; Pulvinar structure; Quality of life; Reading; Rehabilitation therapy; Reporting; Retinal Ganglion Cells; Scanning; Severities; Signal Transduction; Signs and Symptoms; Somatosensory Cortex; Stimulus; Structure of trigeminal ganglion; Symptoms; Syndrome; System; Technology; Testing; Thalamic structure; Therapeutic; Trigeminal Nuclei; Trigeminal System; Veterans; Vision; Work; blood oxygen level dependent; botulinum; clinical pain; design; effective therapy; experience; eye dryness; improved; individual patient; instrument; melanopsin; mental function; multidisciplinary; neuromechanism; ocular pain; pain sensation; pain symptom; painful neuropathy; patient subsets; precision medicine; programs; relating to nervous system; response; sex; social; statistics; sunglasses; targeted treatment; tool; treatment response; treatment strategy

It is estimated that 19% of US veterans have dry eye (DE), of which painful ocular symptoms are a common manifestation. These can include sensations of dryness, burning, and extreme sensitivity to light (i.e., photophobia). The symptoms interfere with activities of daily living including driving and reading. Photophobia, in particular, is one of the most distressing symptoms as its occurrence results in high morbidity without effective treatment. Individuals most severely affected become prisoners in their own homes due to intolerance to even small amounts of light. Even in less severe cases, most individuals have significant functional limitations and often require sunglasses in and outdoors. A knowledge gap exists with regards to the mechanism that underlie these painful sensations, thus limiting the ability to target appropriate treatment strategies. Our overall hypothesis is that photophobia is an indicator of central pathologic plasticity of 1) trigeminal pathways, and 2) their interaction with melanopsin pathways. To test this hypothesis, in aim 1, we define peripheral and central neural responses to light in individuals with chronic ocular pain and photophobia as compared to controls. In aim 2, we examine the contribution of different pathways to photophobia by blocking corneal afferent drive (to assess trigeminal pathways) and intrinsically photosensitive retinal ganglion cell (ipRGC) drive (to assess melanopsin pathways). In Aim 3, we determine the effect of neural blockade with botulinum toxin injection on photophobia. This study is greatly needed, as a critical barrier to progress in the field is the lack of information on neural pathways that underlie disease. The data generated can be used to improve the rehabilitation of ocular pain and increase function and quality of life in veterans and non-veterans alike.

据估计，19%的美国退伍军人患有干眼症（DE），其中眼部疼痛症状很常见