Objective Assessment Of Light Discomfort Thresholds In A Patient With Photoallodynia Treated With Topical 0.01% Naltrexone
Published 2025 - 43rd Congress of the ESCRS
Reference: PP06.14 | Type: Poster | DOI: 10.82333/rcy6-gj54
Authors: Filippo Lixi* 1 , Giulia Coco 2 , Valerio Calabresi 1 , Livio Vitiello 3 , Claudia Corda 1 , Mario Verdiglione 4 , Silvia Costa 4 , Giuseppe Giannaccare 1
1Department of Surgical Sciences,University of Cagliari,Cagliari,Italy, 2Department of Clinical Sciences and Translational Medicine,University of Rome Tor Vergata,Rome,Italy, 3Azienda Sanitaria Locale Salerno,Eye Unit, "Luigi Curto" Hospital,Polla,Italy, 4Farmacia Europea,Compounding Pharmacy,Catanzaro,Italy
Purpose
To report the successful outcomes of naltrexone eye drops used off-label in a patient with severe photoallodynia refractory to previous topical treatments (eyelid hygiene, lubricants, corticosteroids, cyclosporine, autologous serum).
Setting
Eye Clinic, University Hospital.
Methods
A 68-year-old female patient with Sjogren syndrome was treated with naltrexone 0.01% eye drops 4 times daily in both eyes. Patient symptoms were evaluated using a visual analogue scale (VAS). Light discomfort thresholds under different lighting conditions: continuous warm, continuous cold and flashing warm were measured using the Lumiz 100 device (Essilor International, Paris, France). All the evaluations were performed at baseline, 2 minutes after topical anesthesia, and after 1 month of therapy with naltrexone eye drops.
Results
At baseline, VAS score was 10. Light discomfort thresholds were 1.83 log10[lux] for continuous warm, 1.79 log10[lux] for continuous cold, and 1.87 log10[lux] for flashing warm. After administration of topical anesthetic, a partial improvement of symptoms was reported, and VAS score decreased to 8. Light sensitivity thresholds slightly increased to 2.06 log10[lux], 2.02 log10[lux] and 2.18 log10[lux], respectively.
Following 1-month treatment with topical naltrexone, patient experienced significant improvement of symptoms, and VAS score decreased to 4. In parallel, light discomfort thresholds increased to 2.78 log10[lux] for continuous warm, 2.82 log10[lux] for continuous cold, and 2.66 log10[lux] for flashing warm.
Conclusions