Progressive retinal thinning in patients with fibromyalgia syndrome: longitudinal study over a period of 5 years

Abstract

PurposeTo quantify changes in visual function parameters and the macular neuroretina of patients with Fibromyalgia (FM) over a period of 5 years, and to compare with changes in healthy controls.MethodsEighty patients with FM and 38 age and sex‐matched healthy controls were recruited for the study. Only one eye per subject was randomly selected and included. All subjects underwent evaluation of visual acuity (VA) by ETDRS charts, contrast sensitivity vision (CSV) using CSV 1000E test and retinal evaluation using Spectralis Optical coherence tomography (OCT). All subjects were re‐evaluated after 5 years to quantify changes in visual function parameters and ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness. Association between progressive structural, functional and disease severity changes was analysed. Additionally, in order to analyse progression depending on disease phenotype, the patients were classified into three different groups and compared.ResultsAfter a period of 5 years of follow‐up, patients with FM showed worse low contrast VA (p = 0.024), and low frequency CSV (p = 0.004). Furthermore, they presented a progressive decrease affecting the GCL thickness (nasal 1, p = 0.004; temporal 1, p < 0.001; inferior 1, p = 0.001) and the RNFL (nasal 1 and 2, p < 0.001; superior 1, p < 0.001; and inferior 1, p = 0.002). Changes affecting the GCL were correlated with progression in disease severity scores (EQ‐5D, r = 0.560, p < 0.001; FIQ, r = −0.470, p = 0.003). Correlations between structural changes and disease severity scores were only observed in the atypical and biologic phenotypes.ConclusionsPatients with FM present progressive retinal neurodegeneration and visual function changes with time. The evaluation of visual parameters and GCL/RNFL thickness using SD‐OCT could constitute a useful tool in monitoring FM progression.