Disclosed are devices, systems and methods for non-invasive
neuromodulation system for treating inherited or acquired
retinal, choroidal and
optic nerve disorders caused by acute or chronic dysregulated reduced ocular
blood flow (OBF) and / or energy failure by up regulation of trigemino-vascular
system (TVS), trigeminal autonomic brain reflexes (TABRs) and pancreatic trigemino-vagal
reflex (TVR) through stimulation of ophthalmic nerve (V1), more specifically but not limited to SP, and CGRP containing unmyelinated C nerve fibers. The invention, in some embodiments thereof, relates to the methods for enhancing SP and CGRP expression in neurovascular tissue of the
retina and
choroid. The invention, in some embodiments thereof, relates to SP / CGRP mediated pathways, including those involved in vasodilatation, augmentation of OBF, RPE proliferation, prevention of
apoptosis, suppressing
neuroinflammation, promoting migration and differentiation of vascular endothelial cells as well as mobilization of endogenous mesenchymal stem cells (EMSCs) from the
bone marrow to the circulation to accelerate
tissue repair. The site of stimulation of V1 nerve includes but not limited to;
nasal vestibule nasal bridge,
forehead, and upper eyelids. Additionally or alternatively, the subject's
sympathetic nervous system (SNS) is down regulated by sympatholytic agents specifically antioxidants. The subject's TVS and
autonomic nervous system (ANS) are modulated in a manner that is effective to treat the subject for
retinal, choroidal and / or
optic nerve disorders. In some embodiments, the devices are handheld, portable with
nose supported, having one or more intra-nasal or extra-nasal application heads. The
signal can include vibration, chemical, ultrasonic, optical, electrical,
hybrid electro-optical or combination of two or more of these types of stimuli. The invention, in some embodiments thereof, relates to a method for decreasing
vascular resistance, enhancing vasodilatation in ophthalmic
artery and its branches by the release of
Vasoactive intestinal
peptide (VIP),substance P and CGRP thereof increasing OBF to the
retina,
choroid and
optic nerve in subject's with acute or chronic dysregulated, reduced OBF. The invention, in some embodiments thereof, is also related to the methods for improving delivery of
oxygen, glucose,
vitamin A, humoral mediators, growth factors, stem cells and pharmacological agents to the targeted tissues of the
retina,
choroid and optic nerve. The invention, in some embodiments thereof, relates to the methods for improving pancreatic
insulin secretion, thereof to enhance
glucose uptake by PRs and other
retinal cells. Additionally or alternatively, the invention relates to restoration of transduction of signaling in cone PRs by ONS induced glutamate release. The methods of the invention, in some embodiments thereof, include priming of the
retina choroid and optic nerve thereof to enhance the
efficacy of
cell transplantation therapy. The methods of the invention, in some embodiments thereof, also include identifying a subject prone to or suffering from a
disease or condition associated with reduced OBF. Methods of the invention, in some embodiments thereof, may also include monitoring the subject for
prophylactic treatment where the patients are at pre-clinical stage of the
disease. The OBF of subjects who had received
neuromodulation treatment may also be monitored for re-treatment.The present invention, in some embodiments thereof, relates to a method and / or device for treatment of dysregulated reduced blood (e.g. reduced ocular
blood flow) and, more particularly, but not exclusively, to methods and / or devices for treatment retinal, choroidal and optic nerve disorders. Optionally, treatment may include application of an effective amount of ONS ophthalmic
nerve stimulation alone and / or in combination with pen-ocular administration of substance Neuropeptides /
Platelet Rich
Plasma (N / PRP) and / or
ascorbic acid as a sympatholytic agent