Evidence of central sensitisation in those with dry eye symptoms and neuropathic-like ocular pain complaints: incomplete response to topical anaesthesia and generalised heightened sensitivity to evoked pain

Crane, Ashley M.; Feuer, William J.; Felix, Elizabeth R.; Levitt, Roy C.; McClellan, Allison L.; Sarantopoulos, Konstantinos D.; Galor, Anat

doi:10.1136/bjophthalmol-2016-309658

Cited by 69 publications

(46 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 1 – 3 Conservative therapies are sufficient to manage symptoms in mild DE 4 , 5 ; however, management in more severe cases has proved difficult. 6 – 8 An alternative approach would be to directly target receptor molecules on corneal nociceptors. The properties and expression of transducer receptor channels on corneal nociceptors are well described 9 , 10 ; however, the effects of chronic inflammation on corneal polymodal and mechano-nociceptors are less certain.…”

mentioning

confidence: 99%

TRPV1 and TRPM8 Channels and Nocifensive Behavior in a Rat Model for Dry Eye

Bereiter

Rahman

Thompson

et al. 2018

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

PurposePersistent ocular surface pain occurs in moderate to severe dry eye disease (DE); however, the mechanisms that underlie this symptom remain uncertain. The aim of this study was to determine if the transient receptor potential vanilloid ion channels play a role in hypertonic saline (HS)-evoked corneal reflexes in a model for aqueous tear deficient DE.MethodsEye wipe behavior and orbicularis oculi muscle activity (OOemg) were measured after ocular instillation of HS, capsaicin, or menthol 14 days after exorbital gland removal. Total RNA and protein were measured from anterior eye segment and trigeminal ganglia of sham and DE rats.ResultsEye wipe behavior was enhanced in DE rats after HS and capsaicin instillation, but not after menthol when compared to sham rats. DE rats displayed greater OOemg activity after HS and capsaicin, but not after menthol, compared to sham rats. HS-evoked OOemg activity was reduced by selective TRPV1 antagonists and by coapplication of capsaicin plus QX-314, a charged lidocaine derivative. Menthol did not affect OOemg activity; however, selective antagonism of TRPM8 reduced HS-evoked OOemg activity. TRPV1 protein levels were increased in anterior eye segment and trigeminal ganglion samples from DE rats, whereas TRPM8 levels were not affected.ConclusionsThese results suggest that TRPV1 plays a significant role in mediating enhanced nocifensive behavior in DE, while TRPM8 may play a lesser role. Strategies to target specific transducer molecules on corneal nerves may prove beneficial as adjunct therapies in managing ocular pain in moderate to severe cases of DE.

show abstract

mentioning

confidence: 99%

TRPV1 and TRPM8 Channels and Nocifensive Behavior in a Rat Model for Dry Eye

Bereiter

Rahman

Thompson

et al. 2018

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

show abstract

“…Furthermore, the OSDI provides one total score to classify disease severity, but individual questions actually address different root causes of DED. For example, the questions regarding pain triggered by wind and light may indicate a neuropathic etiology of DED 10,77…”

Section: Resultsmentioning

confidence: 99%

Clinical utility of cyclosporine (CsA) ophthalmic emulsion 0.05% for symptomatic relief in people with chronic dry eye: a review of the literature

Rhee¹,

Mah

2017

OPTH

View full text Add to dashboard Cite

To review the literature on the efficacy of cyclosporine (CsA) ophthalmic emulsion 0.05% on symptomatic relief in chronic dry eye disease. There is consistent evidence of objective improvements in chronic dry eye disease (Schirmer score, corneal and interpalpebral dye staining, and tear breakup time) with CsA, but variable results with symptomatic improvement, possibly due to patient tolerance of CsA, similar comforting effect with artificial tears and CsA vehicle, and the inherent subjective nature of symptom monitoring and analysis. This review explores the literature on CsA with special attention to symptomatic relief.

show abstract

“…The 0.5% proparacaine challenge test is a useful method to assess the central sensitization of ocular pain in a general clinical setting which does not provide research equipment such as esthesiometry or confocal microscopy. [10] In previous studies, patients with complete relief of pain after proparacaine administration were classi ed into the peripheral sensitization group, those with consistent pain without relief were classi ed into the central sensitization group, and those with partial relief were classi ed into the mixed sensitization group. [10] Dieckmann et al [6] reported that most of the patients showed partial improvement in pain, suggesting that central sensitization and peripheral sensitization were mixed, and the rate of contribution to pain depends on the etiology or duration of the disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Dry Eye with Ocular Neuropathic Pain Features: Comparison According to the Types of Sensitization Based on the Ocular Pain Assessment Survey

Kim

Yoon

You

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To compare the clinical characteristics of dry eye patients with ocular neuropathic pain features according to the types of sensitization based on the Ocular Pain Assessment Survey (OPAS).Methods: Cross-sectional study of 33 patients with dry eye and ocular neuropathic pain features. All patients had a comprehensive ophthalmic assessment including detailed history, the intensity and duration of ocular pain, the tear film, ocular surface, and Meibomian gland examination, and OPAS. Patients with <50% improvement in pain intensity after proparacaine challenge test were assigned to the central-dominant sensitization group (central group) and those with ≥50% improvement were assigned to the peripheral-dominant sensitization group (peripheral group). All variables were compared between the two groups.Results: No significant differences were observed in age, sex, underlying diseases, history of ocular surgery, duration of ocular pain, tear film, ocular surface and Meibomian gland parameters (all p>0.05). Ocular pain and non-ocular pain severity and the percentage of time spent thinking about non-ocular pain were significantly higher in the central group than in the peripheral group (all p<0.05). Central group complained more commonly of a burning sensation than did the peripheral group (p=0.01).Conclusions: Patients with central-dominant sensitization may experience more intense ocular and non-ocular pain than the others and burning sensation may be a key symptom in those patients.

show abstract

Evidence of central sensitisation in those with dry eye symptoms and neuropathic-like ocular pain complaints: incomplete response to topical anaesthesia and generalised heightened sensitivity to evoked pain

Abstract: Individuals with DE symptoms and persistent ocular pain after topical proparacaine (a marker of central sensitisation to pain) more frequently report NOP-like symptoms and demonstrate increased sensitivity to evoked pain.

Cited by 69 publications

References 32 publications

TRPV1 and TRPM8 Channels and Nocifensive Behavior in a Rat Model for Dry Eye

TRPV1 and TRPM8 Channels and Nocifensive Behavior in a Rat Model for Dry Eye

Clinical utility of cyclosporine (CsA) ophthalmic emulsion 0.05% for symptomatic relief in people with chronic dry eye: a review of the literature

Clinical Characteristics of Dry Eye with Ocular Neuropathic Pain Features: Comparison According to the Types of Sensitization Based on the Ocular Pain Assessment Survey

Contact Info

Product

Resources

About