Interventional Management Of Neuropathic Ocular Pain – A Scoping Review

Abstract

Neuropathic Ocular Pain (NOP) is a debilitating and refractory pain condition. This scoping review is the first to summarize the current evidence of efficacy of interventional treatment options for NOP. Databases were searched for studies published up to March 31, 2023. Two reviewers screened and extracted data, and performed the risk of bias analysis. Twelve studies were included, consisting of 4 cohort studies and 8 case series/reports, with a total of 87 patients. Eight interventions were defined: stellate ganglion block (n=1), trigeminal nerve blocks (n=3), retrobulbar block (n=1), pulsed radiofrequency of sphenopalatine ganglion (n=1), Onabotulinum-Toxin A(n=1), trigeminal nerve stimulation (n=1), intrathecal drug delivery (n=1) and transcutaneous electrical trigeminal nerve stimulation (n=3). Procedures were found to be safe and demonstrated analgesic effect. Follow-up ranged from 24h to 12 months. Substantial heterogeneity across studies was found, and quality was deemed low and of moderate risk of bias. High-quality studies are urgently needed.