Progressive visual dysfunction and retinal neurodegeneration in patients with fibromyalgia

Pathophysiology of fibromyalgia is still not well known. There are certain theories than point out a possible neurodegeneration component.

To evaluate variations in visual function parameters and in the macular ganglion cell layer (CGR) of patients with fibromyalgia (FM) over a period of 5 years, and compare these results with controls.

85 patients with FM and 41 healthy subjects underwent a complete ophthalmic evaluation, including assessment of visual acuity (VA) with ETDRS, contrast sensitivity vision (CSV) with Pelli Robson, color vision with Farnsworth and Lanthony D15 tests and retinal evaluation using Cirrus HD-OCT 3000 (Carl Zeiss, California). All subjects were re-evaluated after 5 years. It was also analyzed the association between progressive structural, functional and disease severity changes. Furthermore, patients were classified into three groups (1, atypical; 2, depressive; 3, biologic).

Progressive changes were detected in visual function parameters and CGR thickness in FM patients after 5 years. Patients with FM presented worse low contrast VA (p = 0.022), color discrimination (Lanthony's C index, p = 0.006) and decreased CGR thickness (nasal inferior, p < 0.001) over the follow up time, compared with controls. Changes in color vision were associated with CGR thinning, but no correlations with disease severity were observed.

It has been noticed progressive visual dysfunction and CGR loss in patients suffering from FM. The analysis of visual function parameters and CGR thickness using Cirrus OCT could be of value to control FM disease.