A型肉毒毒素对具有神经性特征的眼痛的影响。

IF 5.6 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface Pub Date : 2025-02-12 DOI:10.1016/j.jtos.2025.02.007

Elyana V.T. Locatelli , Jaxon J. Huang , Jason D. Betz , Jordan J. Huang , Nicole B. Kantor , Nicholas Reyes , Elizabeth R. Felix , Wendy W. Lee , Anat Galor

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引用次数: 0

摘要

目的：探讨A型肉毒毒素（BoNT-A）对神经性/伤害性眼痛（NOP）的影响，并确定患者预后的预测因素。方法：回顾性研究接受≥1次BoNT-A注射的有NOP症状（光敏感、风/空气敏感、干眼治疗后持续疼痛）的个体。主要结果测量包括注射后4-6周个体是否（有反应者vs无反应者）以及疼痛改善程度（无反应者vs轻度反应者vs中度反应者vs明显反应者）。比较两组间的人口统计学和临床检查信息。结果：27例患者接受BoNT-A治疗NOP症状。74% （n=20）的患者报告疼痛有所改善，并被归类为应答者。在应答者中，获益程度各不相同，25%报告轻度，45%报告中度，30%报告显着疼痛改善。光敏感性（37%）、风/空气敏感性（33%）和生活质量（QoL）（59%）的改善报告个体较少。80%的应答者和0%的无应答者报告BoNT-A后生活质量有所改善。在检验反应预测因子的多变量模型中（无标记，0-3），纤维肌痛（FM）的存在(β=0.50；P =0.004)预示着更好的反应，而射击痛(β=-0.47；p=0.007)预示着BoNT-A的反应更差，(全模型r2=0.53；结论：在BoNT-A后，大多数人报告眼痛和生活质量得到改善，而较少的人报告光和风/空气敏感性得到改善。一些系统和眼部因素可以预测治疗反应，从而指导治疗。

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Impact of botulinum toxin type A on ocular pain with neuropathic features

Purpose

To investigate the impact of botulinum toxin type A (BoNT-A) on neuropathic/nociplastic ocular pain (NOP) and identify predictors of patient outcomes.

Methods

A retrospective study of individuals with NOP symptoms (light sensitivity, wind/air sensitivity, persistent pain despite dry eye treatment) who received ≥1 BoNT-A injection. Primary outcome measures included if (responders vs. non-responders) and to what degree (none vs. mild vs. moderate vs. marked) individuals experienced pain improvement 4–6 weeks post-injection. Demographics and clinical exam information was compared between the groups.

Results

27 individuals received BoNT-A for NOP symptoms. 74 % (n = 20) reported an improvement in pain and were classified as responders. Among responders, the degree of benefit varied, with 25 % reporting mild, 45 % moderate, and 30 % marked pain improvement. Improvements in light sensitivity (37 %), wind/air sensitivity (33 %), and quality of life (QoL) (59 %) were reported by fewer individuals. 80 % of responders and 0 % of non-responders reported QoL improvements afer BoNT-A. In a multivariable model that examined predictors of response (none to marked, 0–3), the presence of fibromyalgia (FM) (β = 0.50; p = 0.004) portended a better response, while shooting pain (β = −0.47; p = 0.007) portended a worse response to BoNT-A, (full model r² = 0.53; p < 0.001). Degree of pain improvement significantly correlated with improvements in light sensitivity, wind/air sensitivity, and QoL (ρ range: 0.42–0.63; p < 0.05).

Conclusion

After BoNT-A, most individuals reported improved ocular pain and QoL, while fewer noted improved light and wind/air sensitivity. Some systemic and ocular factors predicted treatment response and may thus guide treatment.

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来源期刊

Ocular Surface 医学-眼科学

CiteScore

11.60

自引率

14.10%

发文量

审稿时长

39 days

期刊介绍： The Ocular Surface, a quarterly, a peer-reviewed journal, is an authoritative resource that integrates and interprets major findings in diverse fields related to the ocular surface, including ophthalmology, optometry, genetics, molecular biology, pharmacology, immunology, infectious disease, and epidemiology. Its critical review articles cover the most current knowledge on medical and surgical management of ocular surface pathology, new understandings of ocular surface physiology, the meaning of recent discoveries on how the ocular surface responds to injury and disease, and updates on drug and device development. The journal also publishes select original research reports and articles describing cutting-edge techniques and technology in the field. Benefits to authors We also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services. Please see our Guide for Authors for information on article submission. If you require any further information or help, please visit our Support Center