title: Thin-film optical notch filter spectacle coatings for the treatment of migraine and photophobia.
abstract: Previous evidence suggests optical treatments hold promise for treating migraine and photophobia. We designed an optical notch filter, centered at 480nm 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 480nm; a 620nm filter was designed as a sham. Participants were asked to wear lenses with one of the filters for 2weeks; after 2weeks when no lenses were worn, they wore lenses with the other filter for 2weeks. Of 48 subjects, 37 completed the study. Wearing either the 480 or 620nm lenses resulted in clinically and statistically significant HIT-6 reductions. However, there was no significant difference when comparing overall effect of the 480 and 620nm lenses. Although the 620nm 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 620nm filter. These preliminary findings indicate that lenses outfitted with a thin-film optical notch filter may be useful in treating chronic migraine.
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132, USA.
authors.forename: Ryan N
authors.initials: RN
authors.lastname: Hoggan
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132, USA.
authors.forename: Amith
authors.initials: A
authors.lastname: Subhash
authors.affiliation: Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Blair
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132, USA; Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Digre
authors.affiliation: Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Baggaley
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132, USA.
authors.forename: Jamison
authors.initials: J
authors.lastname: Gordon
authors.affiliation: Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Brennan
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132, USA; Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Judith E A
authors.initials: JE
authors.lastname: Warner
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132, USA.
authors.forename: Alison V
authors.initials: AV
authors.lastname: Crum
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132, USA; Department of Neurology, University of Utah, Salt Lake City, UT, USA. Electronic address: Bradley.Katz@hsc.utah.edu.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004867:Equipment Design; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008027:Light / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000517:prevention & control*; D020795:Photophobia / Q000209:etiology / Q000517:prevention & control*; D012165:Retinal Ganglion Cells / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Intrinsically photosensitive retinal ganglion cells; Light sensitivity; Melanopsin; Migraine; Photophobia; Thin-film