The Relation Between Light-Induced Lacrimation and the Melanopsin-Driven Postillumination Pupil Response

Lei, Shaobo; Goltz, Herbert C.; Chen, Xingqiao; Zivcevska, Marija; Wong, Agnes M. F.

doi:10.1167/iovs.16-21285

Cited by 14 publications

(15 citation statements)

References 28 publications

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“…1 a). Although they represent a small fraction (∼1%–3%) of the total retinal ganglion cell population, 1 – 4 ipRGCs are critical for entrainment of circadian rhythm, 5 , 6 aversive responses to light, 7 light-induced lacrimation, 8 and control of pupil diameter. 9 – 11 Disruption of these reflexive visual functions is seen in many clinical conditions, leading to the speculation that dysfunction in the melanopsin system is responsible.…”

mentioning

confidence: 99%

Pulses of Melanopsin-Directed Contrast Produce Highly Reproducible Pupil Responses That Are Insensitive to a Change in Background Radiance

McAdams

Igdalova

Spitschan

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PurposeTo measure the pupil response to pulses of melanopsin-directed contrast, and compare this response to those evoked by cone-directed contrast and spectrally narrowband stimuli.MethodsThree-second unipolar pulses were used to elicit pupil responses in human subjects across three sessions. Thirty subjects were studied in session 1, and most returned for sessions 2 and 3. The stimuli of primary interest were “silent substitution” cone- and melanopsin-directed modulations. Red and blue narrowband pulses delivered using the post-illumination pupil response (PIPR) paradigm were also studied. Sessions 1 and 2 were identical, whereas session 3 involved modulations around higher radiance backgrounds. The pupil responses were fit by a model whose parameters described response amplitude and temporal shape.ResultsGroup average pupil responses for all stimuli overlapped extensively across sessions 1 and 2, indicating high reproducibility. Model fits indicate that the response to melanopsin-directed contrast is prolonged relative to that elicited by cone-directed contrast. The group average cone- and melanopsin-directed pupil responses from session 3 were highly similar to those from sessions 1 and 2, suggesting that these responses are insensitive to background radiance over the range studied. The increase in radiance enhanced persistent pupil constriction to blue light.ConclusionsThe group average pupil response to stimuli designed through silent substitution provides a reliable probe of the function of a melanopsin-mediated system in humans. As disruption of the melanopsin system may relate to clinical pathology, the reproducibility of response suggests that silent substitution pupillometry can test if melanopsin signals differ between clinical groups.

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confidence: 99%

Pulses of Melanopsin-Directed Contrast Produce Highly Reproducible Pupil Responses That Are Insensitive to a Change in Background Radiance

McAdams

Igdalova

Spitschan

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…An objective assessment tool for photophobia is important not just for diagnosis, but also to monitor changes over time and evaluate treatment efficacy. Several efforts have been made toward the development of objective techniques using involuntary light-induced behavioral responses, such as squinting 22,33 and lacrimation, 15 as markers for photophobia. These physiologic behavioral indices, however, can be invasive, are often not closely aligned with the clinical complaint of photophobia, and may not be useful in quantifying light sensitivity for individuals with aberrant blink responses (e.g., as seen in benign essential blepharospasm) and aberrant lacrimal responses (e.g., as seen in dry eye syndrome).…”

mentioning

confidence: 99%

A Novel Visual Psychometric Test for Light-Induced Discomfort Using Red and Blue Light Stimuli Under Binocular and Monocular Viewing Conditions

Zivcevska

Lei

Blakeman

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Ten participants with episodic migraine with or without aura (6 with aura, 9 females, mean age 34 ± 8.7 years, age range 22–49 years) and 11 visually normal controls (5 females, mean age 25 ± 6.6 years, age range 18–42 years) with no history of migraines or photophobia were included in this study. Control data sample has been previously published [ 29 ]. All participants with migraine fulfilled the diagnostic criteria of the International Classification of Headache Disorders III [ 31 ] and had confirmed migraine diagnosis by a licensed clinician, with no other neurologic abnormalities or history of traumatic brain injury (see Table 1 for clinical features).…”

Section: Methodsmentioning

confidence: 99%

“…We recently used simultaneous chromatic pupillometry recording and light-induced lacrimation measurement to investigate photo-sensitivity (a phenomenon closely associated with photophobia) in normal participants. We found that these two phenomena are highly correlated, and that both are mediated predominantly by melanopsin-induced ipRGC photoactivity [ 29 ]. However, photophobia and light-induced lacrimation, as well as their underlying mechanisms, have not been well-studied in patients with migraine.…”

Section: Introductionmentioning

confidence: 99%

Investigation of light-induced lacrimation and pupillary responses in episodic migraine

et al. 2020

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The purpose of this pilot study was to investigate the light-induced pupillary and lacrimation responses mediated by intrinsically photosensitive retinal ganglion cells (ipRGCs) in migraine. Ten participants with episodic migraine and normal tear production, as well as eleven visually normal controls participated in this study. Following an initial baseline trial (no light flash), participants received seven incremental and alternating red and blue light flashes. Pupillometry recording of the left eye and a 1-min anesthetized Schirmer’s test of the right eye (using 0.5% proparacaine) were performed simultaneously. Intrinsic and extrinsic ipRGC photoactivities did not differ between migraine participants and controls across all intensities and wavelengths. Migraine participants, however, had significantly lower lacrimation than controls following the highest blue intensity. A positive correlation was found between melanopsin-driven post-illumination pupillary responses and lacrimation following blue stimulation in both groups. Our results show that participants with self-reported photophobia have normal ipRGC-driven responses, suggesting that photophobia and pupillary function may be mediated by distinct ipRGC circuits. The positive correlation between melanopsin-driven pupillary responses and light-induced lacrimation suggests the afferent arm of the light-induced lacrimation reflex is melanopsin-mediated and functions normally in migraine. Lastly, the reduced melanopsin-mediated lacrimation at the highest stimulus suggests the efferent arm of the lacrimation reflex is attenuated under certain conditions, which may be a harbinger of dry eye in migraine.

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The Relation Between Light-Induced Lacrimation and the Melanopsin-Driven Postillumination Pupil Response

Abstract: Citation: Lei S, Goltz HC, Chen X, Zivcevska M, Wong AMF. The relation between light-induced lacrimation and the melanopsin-driven postillumination pupil response. Invest Ophthalmol Vis Sci.

Cited by 14 publications

References 28 publications

Pulses of Melanopsin-Directed Contrast Produce Highly Reproducible Pupil Responses That Are Insensitive to a Change in Background Radiance

Pulses of Melanopsin-Directed Contrast Produce Highly Reproducible Pupil Responses That Are Insensitive to a Change in Background Radiance

A Novel Visual Psychometric Test for Light-Induced Discomfort Using Red and Blue Light Stimuli Under Binocular and Monocular Viewing Conditions

Investigation of light-induced lacrimation and pupillary responses in episodic migraine

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