Highlights
- •Migraine is associated with photophobia, an abnormal intolerance to light.
- •Light stimulates intrinsically photosensitive retinal ganglion cells (IPRGCs).
- •We designed an optical notch filter to reduce direct stimulation of IPRGCs.
- •Our objective was to determine if wearing the filter could reduce migraine impact.
- •Thin-film optical notch filters may be useful in treating chronic migraine.
Abstract
Previous evidence suggests optical treatments hold promise for treating migraine and
photophobia. We designed an optical notch filter, centered at 480 nm to reduce direct stimulation of intrinsically photosensitive retinal ganglion cells.
We used thin-film technology to integrate the filter into spectacle lenses. Our objective
was to determine if an optical notch filter, designed to attenuate activity of intrinsically
photosensitive retinal ganglion cells, could reduce headache impact in chronic migraine
subjects. For this randomized, double-masked study, our primary endpoint was the Headache
Impact Test (HIT-6; GlaxoSmithKline, Brentford, Middlesex, UK). We developed two filters:
the therapeutic filter blocked visible light at 480 nm; a 620 nm filter was designed as a sham. Participants were asked to wear lenses with one
of the filters for 2 weeks; after 2 weeks when no lenses were worn, they wore lenses with the other filter for 2 weeks. Of 48 subjects, 37 completed the study. Wearing either the 480 or 620 nm lenses resulted in clinically and statistically significant HIT-6 reductions. However,
there was no significant difference when comparing overall effect of the 480 and 620 nm lenses. Although the 620 nm filter was designed as a sham intervention, research published following the trial
indicated that melanopsin, the photopigment in intrinsically photosensitive retinal
ganglion cells, is bi-stable. This molecular property may explain the unexpected efficacy
of the 620 nm filter. These preliminary findings indicate that lenses outfitted with a thin-film
optical notch filter may be useful in treating chronic migraine.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: February 27, 2016
Accepted:
September 29,
2015
Received:
February 9,
2015
Identification
Copyright
© 2015 Elsevier Ltd. All rights reserved.
