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Erschienen in: Acta Neurologica Belgica 2/2021

27.05.2019 | Original article

Is gabapentin effective in dry eye disease and neuropathic ocular pain?

verfasst von: Nedim Ongun, Gulin Tugba Ongun

Erschienen in: Acta Neurologica Belgica | Ausgabe 2/2021

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Abstract

This study aims to evaluate the efficacy of gabapentin treatment in dry eye disease (DED) and neuropathic ocular pain. Our study was performed with 72 patients. The painDETECT questionnaire was used for neuropathic pain screening. Patients who were thought to have severe DED according to ocular surface disease index (OSDI) questionnaire, Schirmer’s test type 1 and tear break up time test results were treated with artificial tear and cyclosporine drops. Gabapentin treatment was also initiated in addition to artificial tear and cyclosporine drops treatments to the patients with neuropathic component and DED findings. We divided the patients into two groups: group 1 (n: 36), patients treated with artificial tear and cyclosporine drops and group 2 (n: 36), patients treated with artificial tear, cyclosporine drops and gabapentin. In the first evaluation, no significant differences were found between groups in terms of OSDI score, Schirmer’s test result and TBUT. After the 6 weeks of treatment, in both groups OSDI score, Schirmer’s test result and TBUT statistically significantly improved. OSDI score, Schirmer’s test result and TBUT significantly improved after the 6 weeks of gabapentin treatment than artificial tear and cyclosporine treatment group (p < 0.001). Dry eye patients should be screened for neuropathic ocular pain symptoms and individualized treatment has to be applied. Our study showed that the use of gabapentin is effective in severe dry eye patients with neuropathic ocular pain.
Literatur
1.
Zurück zum Zitat The epidemiology of dry eye disease (2007) Report of the epidemiology subcommittee of the international dry eye workshop. Ocul Surf 5:93–107CrossRef The epidemiology of dry eye disease (2007) Report of the epidemiology subcommittee of the international dry eye workshop. Ocul Surf 5:93–107CrossRef
2.
Zurück zum Zitat Galor A, Feuer W, Lee DJ, Florez H, Venincasa VD, Perez VL (2013) Ocular surface parameters in older male veterans. Investig Ophthalmol Vis Sci 54:1426–1433CrossRef Galor A, Feuer W, Lee DJ, Florez H, Venincasa VD, Perez VL (2013) Ocular surface parameters in older male veterans. Investig Ophthalmol Vis Sci 54:1426–1433CrossRef
3.
Zurück zum Zitat Guthoff RF, Wienss H, Hahnel C, Wree A (2005) Epithelial innervation of human cornea: a three-dimensional study using confocal laser scanning fluorescence microscopy. Cornea 24:608–613CrossRef Guthoff RF, Wienss H, Hahnel C, Wree A (2005) Epithelial innervation of human cornea: a three-dimensional study using confocal laser scanning fluorescence microscopy. Cornea 24:608–613CrossRef
4.
Zurück zum Zitat Belmonte C, Acosta MC, Merayo-Lloves J et al (2015) What causes eye pain? Curr Ophthalmol Rep 3:111–121CrossRef Belmonte C, Acosta MC, Merayo-Lloves J et al (2015) What causes eye pain? Curr Ophthalmol Rep 3:111–121CrossRef
5.
Zurück zum Zitat Kalangara JP, Galor A, Levitt RC, Felix ER, Alegret R, Sarantopoulos CD (2016) Burning eye syndrome: do neuropathic pain mechanisms underlie chronic dry eye? Pain Med 17(4):746–755PubMed Kalangara JP, Galor A, Levitt RC, Felix ER, Alegret R, Sarantopoulos CD (2016) Burning eye syndrome: do neuropathic pain mechanisms underlie chronic dry eye? Pain Med 17(4):746–755PubMed
6.
Zurück zum Zitat Galor A, Levitt RC, Felix ER, Martin ER, Sarantopoulos CD (2015) Neuropathic ocular pain: an important yet underevaluated feature of dry eye. Eye (Lond) 29(3):301–312CrossRef Galor A, Levitt RC, Felix ER, Martin ER, Sarantopoulos CD (2015) Neuropathic ocular pain: an important yet underevaluated feature of dry eye. Eye (Lond) 29(3):301–312CrossRef
7.
Zurück zum Zitat Goyal S, Hamrah P (2016) Understanding neuropathic corneal pain—gaps and current therapeutic approaches. Semin Ophthalmol 31(1–2):59–70CrossRef Goyal S, Hamrah P (2016) Understanding neuropathic corneal pain—gaps and current therapeutic approaches. Semin Ophthalmol 31(1–2):59–70CrossRef
8.
Zurück zum Zitat Attal N, Cruccu G, Haanpää M, Hansson P, Jensen TS, Nurmikko T, Sampaio C, Sindrup S, Wiffen P (2006) EFNS Task Force. EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol 13:1153–1169CrossRef Attal N, Cruccu G, Haanpää M, Hansson P, Jensen TS, Nurmikko T, Sampaio C, Sindrup S, Wiffen P (2006) EFNS Task Force. EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol 13:1153–1169CrossRef
9.
Zurück zum Zitat Lichtinger A, Purcell TL, Schanzlin DJ, Chayet AS (2011) Gabapentin for postoperative pain after photorefractive keratectomy: a prospective, randomized, double-blind, placebo-controlled trial. J Refract Surg 27(8):613–617CrossRef Lichtinger A, Purcell TL, Schanzlin DJ, Chayet AS (2011) Gabapentin for postoperative pain after photorefractive keratectomy: a prospective, randomized, double-blind, placebo-controlled trial. J Refract Surg 27(8):613–617CrossRef
10.
Zurück zum Zitat Alkan H, Ardıc F, Erdogan C, Sahin F, Sarsan A, Findikoglu G (2013) Turkish Version of the painDETECT Questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med 14:1933–1943CrossRef Alkan H, Ardıc F, Erdogan C, Sahin F, Sarsan A, Findikoglu G (2013) Turkish Version of the painDETECT Questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med 14:1933–1943CrossRef
11.
Zurück zum Zitat Irkec MT, Turkish OSDI Study Group (2007) Reliability and validity of turkish translation of the ocular surface disease index (OSDI) in dry eye syndrome. Investig Ophthalmol Vis Sci 48(13):408 Irkec MT, Turkish OSDI Study Group (2007) Reliability and validity of turkish translation of the ocular surface disease index (OSDI) in dry eye syndrome. Investig Ophthalmol Vis Sci 48(13):408
12.
Zurück zum Zitat Jensen TS, Baron R, Haanpaa M et al (2011) A new definition of neuropathic pain. Pain 152(10):2204–2205CrossRef Jensen TS, Baron R, Haanpaa M et al (2011) A new definition of neuropathic pain. Pain 152(10):2204–2205CrossRef
13.
Zurück zum Zitat Galor A, Zlotcavitch L, Walter SD et al (2015) Dry eye symptom severity and persistence are associated with symptoms of neuropathic pain. Br J Ophthalmol 99(5):665–668CrossRef Galor A, Zlotcavitch L, Walter SD et al (2015) Dry eye symptom severity and persistence are associated with symptoms of neuropathic pain. Br J Ophthalmol 99(5):665–668CrossRef
14.
Zurück zum Zitat Chao C, Golebiowski B, Stapleton F (2014) The role of corneal innervation in LASIK-induced neuropathic dry eye. Ocul Surf 12(1):32–45CrossRef Chao C, Golebiowski B, Stapleton F (2014) The role of corneal innervation in LASIK-induced neuropathic dry eye. Ocul Surf 12(1):32–45CrossRef
15.
Zurück zum Zitat Spierer O, Felix ER, McClellan AL et al (2016) Corneal mechanical thresholds negatively associate with dry eye and ocular pain symptoms. Investig Ophthalmol Vis Sci 57(2):617–625CrossRef Spierer O, Felix ER, McClellan AL et al (2016) Corneal mechanical thresholds negatively associate with dry eye and ocular pain symptoms. Investig Ophthalmol Vis Sci 57(2):617–625CrossRef
16.
Zurück zum Zitat Vehof J, Kozareva D, Hysi PG et al (2013) Relationship between dry eye symptoms and pain sensitivity. JAMA Ophthalmol 131(10):1304–1308CrossRef Vehof J, Kozareva D, Hysi PG et al (2013) Relationship between dry eye symptoms and pain sensitivity. JAMA Ophthalmol 131(10):1304–1308CrossRef
17.
Zurück zum Zitat Crane AM, Levitt RC, Felix ER, Sarantopoulos KD, McClellan AL, Galor A (2017) Patients with more severe symptoms of neuropathic ocular pain report more frequent and severe chronic overlapping pain conditions and psychiatric disease. Br J Ophthalmol 101(2):227–231CrossRef Crane AM, Levitt RC, Felix ER, Sarantopoulos KD, McClellan AL, Galor A (2017) Patients with more severe symptoms of neuropathic ocular pain report more frequent and severe chronic overlapping pain conditions and psychiatric disease. Br J Ophthalmol 101(2):227–231CrossRef
18.
Zurück zum Zitat McMonnies CW (2017) The potential role of neuropathic mechanisms in dry eye syndromes. J Optom 10(1):5–13CrossRef McMonnies CW (2017) The potential role of neuropathic mechanisms in dry eye syndromes. J Optom 10(1):5–13CrossRef
19.
Zurück zum Zitat Crane AM, Feuer W, Felix ER, Levitt RC, McClellan AL, Sarantopoulos KD, Galor A (2017) Evidence of central sensitisation in those with dry eye symptoms and neuropathic-like ocular pain complaints: incomplete response to topical anaesthesia and generalised heightened sensitivity to evoked pain. Br J Ophthalmol 101(9):1238–1243CrossRef Crane AM, Feuer W, Felix ER, Levitt RC, McClellan AL, Sarantopoulos KD, Galor A (2017) Evidence of central sensitisation in those with dry eye symptoms and neuropathic-like ocular pain complaints: incomplete response to topical anaesthesia and generalised heightened sensitivity to evoked pain. Br J Ophthalmol 101(9):1238–1243CrossRef
20.
Zurück zum Zitat McGreevy K, Bottros MM, Raja SN (2011) Preventing chronic pain following acute pain: risk factors, preventive strategies, and their efficacy. Eur J Pain Suppl 5:365–372CrossRef McGreevy K, Bottros MM, Raja SN (2011) Preventing chronic pain following acute pain: risk factors, preventive strategies, and their efficacy. Eur J Pain Suppl 5:365–372CrossRef
21.
Zurück zum Zitat Zollner C, Mousa S, Klinger A, Förster M, Schäfer M (2008) Topical fentanyl in a randomized, double-blind study in patients with corneal damage. Clin J Pain 24(8):690–696CrossRef Zollner C, Mousa S, Klinger A, Förster M, Schäfer M (2008) Topical fentanyl in a randomized, double-blind study in patients with corneal damage. Clin J Pain 24(8):690–696CrossRef
22.
Zurück zum Zitat Wenk HN, Nannenga MN, Honda CN (2003) Effect of morphine sulphate eye drops on hyperalgesia in the rat cornea. Pain 105(3):455–465CrossRef Wenk HN, Nannenga MN, Honda CN (2003) Effect of morphine sulphate eye drops on hyperalgesia in the rat cornea. Pain 105(3):455–465CrossRef
Metadaten
Titel
Is gabapentin effective in dry eye disease and neuropathic ocular pain?
verfasst von
Nedim Ongun
Gulin Tugba Ongun
Publikationsdatum
27.05.2019
Verlag
Springer International Publishing
Erschienen in
Acta Neurologica Belgica / Ausgabe 2/2021
Print ISSN: 0300-9009
Elektronische ISSN: 2240-2993
DOI
https://doi.org/10.1007/s13760-019-01156-w

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