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Ett nytt visuellt psykometrisk test för ljusinducerat obehag med användning av röda och blå ljusstimuli under binokulära och monokulära synförhållanden Syftet var att utveckla en objektiv psykofysisk metod för att kvantifiera ljusinducerat visuellt obehag och att mäta effekterna av visuellt tillstånd och stimulusvåglängd. Elva visuellt normala personer deltog i studien. Deras pupiller vidgades (2,5 procent fenylefrin) före experimentet. Ett Ganzfeld-system presenterade antingen röda eller blå, randomiserade ljusintensiteter i fyra block. Konstanta vitljus-stimuli (3 cd / m2, 4 s varaktighet) interfogades i de kromatiska försöken. Deltagarna rapporterade varje stimulans som antingen ‘’obekvämt ljus‘’ eller ‘’inte obekvämt ljus”. Experimentet utfördes binokulärt och monokulärt i separata sessioner, och ordningen för färg/visnings-betingelser var randomiserad över deltagarna. Ljusinducerat obehag var högre under blå jämfört med röd ljusstimulering, både binokulärt och monokulärt seende. Det fanns också en signifikant skillnad i obehag mellan synförhållanden, binokulärt framkallar mer obehag än monokulärt seende för blå (P <0,001), men inte vid röd ljusstimulering. De ljusinducerade obehagen som rapporteras här överensstämmer med den i grunden ljuskänsliga melanopsin-innehållande retinala ganglioncellsvägen, som kan medföra fotofobi, en framträdande egenskap vid många kliniska störningar. Detta är den första psykometriska bedömningen utformad kring melanopsin-spektrala egenskaper som kan anpassas ytterligare för att bedöma fotofobi i olika kliniska populationer.
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Herbert C. Gol
Shaobo da nto, Ontario, Cana , Toronto, Ontario, Canada y of Toronto, Toro Science, Universit ital for Sick Children nto, Ontario, Canada 1 Health, The Hosp Toro Institute of Medical iences and Mental n Sciences, University of Toronto, Canada 2 rio, Program in Neurosc Visio Onta and Canada thalmology ital, Toronto, 3 , Toronto, Ontario, Department of Oph Institute, Toronto Western Hosp ital for Sick Children Hosp arch The , 4 Rese bil nces Scie The Krem ology and Vision thalm Oph 5 of Department -induced visual od to quantify light psychophysical methition and stimulus wavelength. lop an objective ing cond PURPOSE. To deve the effects of view ils were dilated sure s M. F. Wong, pup r mea Agne to Thei ce: y. and nden in the stud Correspo discomfort, thalmology and d either red (1.5, ects participated Department of Oph Hospital for visually normal subj riment. A Ganzfeld system presente , 57.1, 71.4 cd/ The METHODS. Eleven Vision Sciences, before the expe 2 or blue (1.4, 7.1, 14.3, 28.6, 42.9 e) Avey hrin cd/ ersit ylep Univ phen ) (2.5% e-light stimuli (3 3 cd/m Sick Children, 555 ks. Constant whit 76.3, 152.7, 305. rio M5G 1X8, 19.1, 38.2, 57.3, nts reported each s each) in four bloc nue, Toronto, Onta 2 light intensities (1 with the chromatic trials. Participa The experiment m ) randomized t.’’ Canada; d brigh leave inter tably . mfor ds.ca were agnes.wong@sickki m2 , 4 s duration) bright’’ or ‘‘not uncoons, and the order of color/viewing r ‘‘uncomfortably are joint senior in separate sessi ‘‘uncomfortable’’ stimulus as eithe HCG and AMFW The proportion of rly and monocularly from which 50% was done binocula was randomized across participants. authors. etric functions, hom ence psyc sequ l 1, 2017 condition rate individua gene to Submitted: December 2018 used 7, . responses was Accepted: February light stimulation, ds were calculated compared with red discomfort threshol M, Lei S, Blakeman ¼ 3.15, P ¼ higher under blue (t Citation: Zivcevska l uced discomfort was P < 0.01) and monocular viewing (10) s, with g AMF. A novel visua RESULTS. Light-ind A, Goltz HC, Won viewing condition ¼ 3.58, een ced (t -indu betw r t (10) light cula mfor for bino rence in disco blue (P < 0.001), both during psychometric test diffe for nt ing light ifica view blue sign ar a and ocul red t than mon ). There was also mfor discomfort using 0.01 ocudisco e mon mor and cular inducing stimuli under bino s. Invest Ophbinocular viewing stimulation. consistent with ition lar viewing cond s reported here are lion cell light but not for red light ;59:1467–1474. gang mfort characteristic thalmol Vis Sci. 2018 iovs.17-23526 light-induced disco intrinsically photosensitive retinal in many clinical 167/ CONCLUSIONS. The re ing https://doi.org/10.1 featu t ntain inen in-co nops a prom tral features of the mela which may mediate photophobia, melanopsin spec designed around rent clinical irradiance pathway, first psychometric assessment ophobia in diffe the er to assess phot disorders. This is be customized furth can that s propertie l test mfort, psychophysica populations. light-induced disco in, photophobia, Keywords: melanops
Marija Zivcevska,
ar or light-induced ocul sensory state of nthotophobia is a nt tearing and squi t, and/or subseque cranial discomfor neurological and ral seve of sym ptom 1 c brain mati trau , ing. A com mon aine migr rders, including lead to ophthalmic diso photophobia can m, and dry eye,1–3 idinjur y, blepharospas Visually normal indiv in ever yday life. ping into step n whe severe impairment non similar phenome a e room rienc dark a expe in uals also y after being ent ronment, especiall a brightly lit envi tophobia may pres time. Because pho rse clinical for a period of normal and dive y both in visually likel is sly neou ition roge defin hete all’’ 4,5 ting a ‘‘one-size-fitsunderlying populations, adop nomenon, the a complex phe d and require rstoo oversimplifying unde ly h remain poor ‘‘visual mechanisms of whic y, we use the term the tion. In this stud further investiga y experienced by to light sensitivit ’’ to describe obia discomfort’’ to refer toph ‘‘pho population, and visually normal y. ciated with patholog light sensitivity asso
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iating addition to med shows that in rhythm Recent literature es, such as circadian 6–8 the melanopsinisual photorespons unconscious nonv reflex, light llary pupi cell the entrainment and ve retinal ganglion in ally photosensiti role containing intrinsic plays a critical 1,9–16 This is iance pathway irrad light ept. GC) perc (ipR painful information into a ies report transducing light . First, animal stud cone ral lines of evidence supported by seve rodents before rod/ in viors in neonatal melanops in viors light-aversive beha beha e an absence of thes higher a but has ent, ivity lopm oact deve 17,18 Second, ipRGC phot that on-tracking ability knockout mice. d and unique phot levels light irradiance activation threshol coding of ambient efore best ther is allows continuous way path 19 The ipRGC or damaging high without fatigue. potentially irritating gth blue light has velen positioned to code 20–23 whereas uli. Third, short-wa irradiance light stim discomfort, l visua t mos the induce the symptom in been reported to reported to reduce s have been n spec2,24,25 Furthermore, the actio blue-filtering lense ophobia. patients with phot
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Sammanfattning Catarina Ericson
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