Background Fibromyalgia syndrome is a chronic disorder characterized by widespread pain, fatigue, sleep disturbances and cognitive dysfunction. The pathophysiology is still unknown, however, sympathetic dysfunction, central and peripheral sensitization, neuroendocrine anomalies, psychosocial factors can be counted as possible mechanisms. In recent years vascular changes and perfusion anomalies of brain, neuroretina changes have been reported.

Objectives To evaluate the optic nerve and macula findings in female fibromyalgia patients compared with healthy controls and investigate the relations with disease severity.

Methods Sixty-two female fibromyalgia (FMS) patients with a mean age of 43.11±7.94 years and sixty female healthy controls with a mean age of 40±12.26 years were included. Fibromyalgia was diagnosed according to the American College of Rheumatology Criteria. Schirmer and tear break up time (BUT) test were recorded. Choroidal thickness, optic nerve head blood flow area, retinal nerve fiber layer was measured with optic coherence tomography angiography (OCTA). Widespread pain index (WPI), symptom severity scale (SSS), tender point count, Fibromyalgia impact questionnaire (FIQ) were recorded.

Results BUT test findings were lower in FMS patients compared to healthy controls and the differences were statistically significant (p<0.0001). There were no significant differences in Schirmer test and intraocular pressure findings between FMS patients and healthy controls (p>0.05). Optic disc total and peripapillary densities of FMS patients were found to be higher than healthy controls (p<0.05). Choroidal thickness, inner retina perifoveal thickness values of FMS patients were higher than healthy controls (p<0.05) but in outer retina foveal thickness values of patients were lower than healthy controls (p<0.05). In addition, foveal avascular zone (FAZ) and nonflow area were found to be enlarged in FMS patients compared to the healthy controls (p<0.05). There were weak positive correlations between fibromyalgia severity scale and choroidal thickness values, optic disc total and peripapillary densities and FAZ area. In addition, there were weak negative correlations between fibromyalgia severity scale and BUT test values.

Conclusion Due to the known increase in inflammation in FMS patients, we found choroidal thickness and vascular density values around the optic disc to be higher than in the healthy control group. In addition, we found that FAZ and nonflow area values were enlarged compared to the control group, consistent with ischemia due to vascular damage in FMS patients. We found a significant correlation between all these values and the fibromyalgia severity scale values. In conclusion, we think that the results we evaluated with OCTA measurements are useful in detecting damage to retinal and optic disc vascular structures in FMS patients.

Reference [1]Urfalioğlu S, Berk E. Assessment of retinal nerve fiber thickness and optic nerve head blood flow in female patients diagnosed with fibromiyalgia syndrome. Arq Bras Pftalmol 2022;85(1)30-6.

Acknowledgements: NIL.

Disclosure of Interests None Declared.