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

Zivcevska, Marija; Lei, Shaobo; Blakeman, Alan; Goltz, Herbert C.; Wong, Agnes M. F.

doi:10.1167/iovs.17-23526

Cited by 12 publications

(9 citation statements)

References 47 publications

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“…Objective EMG photophobia thresholds (log quanta.cm −2 .s −1 ) were wavelength dependent in both the migraine (F 1,3 = 21.51, p < 0.001) and control groups (F 1,3 = 19.07, p < 0.001) (Figure 1). Thresholds to 630 nm red stimuli were significantly higher than to 461 nm blue stimuli (Bonferroni post-hoc : migraine, mean difference = 0.57, p < 0.001; control, mean difference = 0.50, p < 0.001) and 525 nm green stimuli (migraine, mean difference = 0.67, p < 0.001; control, mean difference = 0.59, p < 0.001), consistent with past reports (14,39,40); there were no significant differences in either group between the EMG photophobia threshold for blue and green lights (migraine, mean difference = 0.10, p = 0.33; control, mean difference = 0.09, p = 0.33). Between-group comparisons revealed that photophobia thresholds in migraineurs were 0.58 log units lower than control participants for blue and green lights (461 nm, t 21 = 5.428, p < 0.001; 525 nm, t 21 = 5.429, p < 0.001) and 0.50 log units lower for red light (630 nm, t 21 = 4.71, p < 0.001) (Figure 1).…”

Section: Resultssupporting

confidence: 89%

Melanopsin hypersensitivity dominates interictal photophobia in migraine

et al. 2020

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Purpose To define the melanopsin and cone luminance retinogeniculate pathway contributions to photophobia in healthy controls and migraineurs. Methods Healthy controls and migraineurs were categorized according to the International Classification of Headache Disorders criteria. Photophobia was measured under full-field illumination using electromyography in response to narrowband lights spanning the melanopsin and cone luminance action spectra. Migraineurs were tested during their interictal headache-free period. Melanopsin-mediated post-illumination pupil responses quantified intrinsically photosensitive Retinal Ganglion Cell (ipRGC) function. Results A model combining the melanopsin and cone luminance action spectra best described photophobia thresholds in controls and migraineurs; melanopsin contributions were ∼1.5× greater than cone luminance. In the illumination range causing photophobia, migraineurs had lower photophobia thresholds (∼0.55 log units; p < 0.001) and higher post-illumination pupil response amplitudes ( p = 0.03) than controls. Conclusion Photophobia is driven by melanopsin and cone luminance inputs to the cortex via the retino-thalamocortical pathway. In migraineurs, lower photophobia thresholds reflect hypersensitivity of ipRGC and cone luminance pathways, with the larger and prolonged post-illumination pupil response amplitude indicative of a supranormal melanopsin response. Our findings inform artificial lighting strategies incorporating luminaires with low melanopsin excitation and photopic luminance to limit the lighting conditions leading to photophobia.

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Section: Resultssupporting

confidence: 89%

Melanopsin hypersensitivity dominates interictal photophobia in migraine

et al. 2020

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“…The experiment was conducted considering the properties of the ipRGCs, using blue (470 nm) and red (635 nm) stimuli. The group’s results, consistent with other studies, reinforce the idea that visually normal subjects are less sensitive to red light stimulation, with higher thresholds of sensitivity, stressing the idea that blue light can generate visual discomfort at much lower levels of intensity than other forms of light [ 30 , 32 , 52 , 97 ]. Eliminating habituation and anticipation errors by using the method of constant stimuli and a randomized sequence of blue and red-light intensities, the authors quantified this perceptual phenomenon and developed a new psychometric test that would bring its benefits in the current new working frame where there is more knowledge about ipRGCs than previously.…”

Section: Discussionsupporting

confidence: 87%

“…Relying on the idea that there is a positive correlation between the stimulated retinal area and melanopsin activity [ 95 , 96 ], Zivcevska et al [ 52 ] postulated that photophobia may be a perceptually summated experience. The authors wanted to evaluate whether, by using the psychophysical method of constant stimuli to assess perceptual response and maintaining consistent retinal stimulation (achieved by using dilating eye drops—Phenylephrine 2.5%), there would be a difference in “visual discomfort” in visually normal subjects in monocular as well as binocular viewing conditions.…”

Section: Discussionmentioning

confidence: 99%

Blue Light—Ocular and Systemic Damaging Effects: A Narrative Review

Antemie

Samoilă

Clichici

2023

IJMS

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Light is a fundamental aspect of our lives, being involved in the regulation of numerous processes in our body. While blue light has always existed in nature, with the ever-growing number of electronic devices that make use of short wavelength (blue) light, the human retina has seen increased exposure to it. Because it is at the high-energy end of the visible spectrum, many authors have investigated the theoretical harmful effects that it poses to the human retina and, more recently, the human body, given the discovery and characterization of the intrinsically photosensitive retinal ganglion cells. Many approaches have been explored, with the focus shifting throughout the years from examining classic ophthalmological parameters, such as visual acuity, and contrast sensitivity to more complex ones seen on electrophysiological assays and optical coherence tomographies. The current study aims to gather the most recent relevant data, reveal encountered pitfalls, and suggest future directions for studies regarding local and/or systemic effects of blue light retinal exposures.

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“…4 A similar setup was used to evaluate light-induced discomfort using red and blue lights. 14 Although these studies designed methods to test photosensitivity thresholds, they were not practical in a clinical setting as they were dependent on bulky instruments creating heat and thermal fluctuations.…”

Section: Introductionmentioning

confidence: 99%

Visual photosensitivity threshold and objective photosensitivity luminance in healthy human eyes assessed using an automated ocular photosensitivity analyser: a step towards translation of a clinical tool for assessing photophobia

Durgam

Bagari

Nandyala

et al. 2021

Ophthalmic Physiologic Optic

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To evaluate the visual photosensitivity threshold and objective photosensitivity luminance in healthy eyes, thereby providing a normative dataset that will lead to a better understanding of diseases causing photophobia. Methods:This was a prospective cross-sectional study. Emmetropes whose visual acuity was better than 0.18 logMAR (6/9) with no other ocular abnormality were included. Headache Impact Test-6 and visual light sensitivity questionnaires were administered. Visual photosensitivity threshold was measured subjectively using the ocular photosensitivity analyser. Objective photosensitivity luminance was assessed manually by evaluating videos recorded using an infrared camera and noting the intensity of light at the first squeezing reflex.Results: Seventy five normal subjects (age range, 7-71 years) were included.Median age was 32.7 years (inter-quartile range, 20.3-47.9 years). Forty (53.3%) were males. Median Headache Impact Test score was 38 (inter-quartile range, 36-42) and visual light sensitivity questionnaire score was 11 (inter-quartile range, 8-15). Mean (standard deviation) right eye, left eye and binocular visual photosensitivity threshold was 3.34 (0.78), 3.33 (0.81) and 3.37 (0.78) loglux, respectively.There was a significant negative correlation of visual light sensitivity questionnaire scores with right eye, left eye and binocular visual photosensitivity thresholds, and positive correlation of age with binocular visual photosensitivity thresholds. Mean (standard deviation) right eye, left eye and binocular objective photosensitivity luminance was 3.25 (0.55), 3.35 (0.47) and 3.15 (0.52) loglux, respectively. Age was only positively correlated with binocular objective photosensitivity luminance, and there was no correlation between age and right eye or left eye objective photosensitivity luminance. Conclusions:The study characterised, for the first time, objective photosensitivity luminance and established normative data for both visual photosensitivity

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

Cited by 12 publications

References 47 publications

Melanopsin hypersensitivity dominates interictal photophobia in migraine

Melanopsin hypersensitivity dominates interictal photophobia in migraine

Blue Light—Ocular and Systemic Damaging Effects: A Narrative Review

Visual photosensitivity threshold and objective photosensitivity luminance in healthy human eyes assessed using an automated ocular photosensitivity analyser: a step towards translation of a clinical tool for assessing photophobia

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