Evaluation of Ophthalmic Vascular and Neural Structures in Female Patients with Fibromyalgia Syndrome and Their Relationship with Disease Severity

Abstract

Purpose This study aimed to evaluate choroidal and macular thickness, as well as vascular structures in female fibromyalgia syndrome (FMS) patients using optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT), and to compare the results with healthy controls. Additionally, the relationship between these findings and disease severity was explored. Methods The study included 62 female FMS patients and 60 healthy controls, conducted between January 2022 and October 2022 at the Antalya Training and Research Hospital. FMS patients were assessed based on American College of Rheumatology criteria. Tear production and stability were evaluated using Schirmer and Tear Break-Up Time (TBUT) tests, while OCTA and OCT were used to examine vascular and choroidal structures. Results The mean age of the FMS group was 43.11 ± 7.94 years. No significant difference was found in the Schirmer test, but the TBUT was significantly lower in the FMS group (p < 0.0001). OCTA showed significantly lower deep capillary plexus (DCP) values in the FMS group, with a weak negative correlation between DCP and disease severity (r=-0.227, p = 0.012). Foveal avascular zone (FAZ), non-flow, and choroidal thickness were significantly higher in FMS patients (p < 0.05). Conclusion The study demonstrated a relationship between dry eye, vascular changes, and increased choroidal thickness with disease severity in female patients with FMS. The reduction in DCP, along with increases in FAZ, non-flow, and choroidal thickness, may be linked to vascular and inflammatory processes involved in FMS pathogenesis. The decrease in tear quality may be due to autonomic nervous system dysfunction. In conclusion, we suggest that autonomic dysfunction and inflammation in FMS may negatively affect retinal vascular structures and tear function.