Can a routine, non-invasive and inexpensive eye exam help diagnose fibromyalgia (FM), and perhaps help guide the disease’s management? That’s a question researchers from Spain investigated, and found that it may well be true.
Using optical coherence tomography (OCT) – a non-invasive imaging test that uses light waves to take cross-section pictures of your retina – researchers detected that the retinal nerve fiber layer (RNFL) is atrophied in people with fibromyalgia, compared to controls.
They studied 116 people with fibromyalgia compared to 144 controls, and published their peer-reviewed study, “Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning,” in this month’s issue of PLOS One
“The main finding in the present study evaluating RNFL parameters in patients with FM was the presence of axonal damage in the optic nerve of FM patients, even in early stages of the disease. Our results revealed that even patients with mild FM (Fibromyalgia Impact Questionnaire <60) exhibited subclinical RNFL atrophy in the temporal sectors,” wrote Elena Garcia-Martin, lead author of the study, and colleagues.
“The ability to evaluate the optic nerve as an indicator of the disease is an important advance,” they added.
The researchers also detected differences between fibromyalgia subgroups. Specifically, those with biologic fibromyalgia, which is characterized by low depression and anxiety, but with high pain, had a significant decrease retinal nerve fiber layer in the temporal inferior and temporal superior areas compared to those who suffer from depressive or atypical fibromyalgia.
“Ophthalmologic tests are new, noninvasive, and cost-effective tools than can be used to facilitate the diagnosis of FM and may reduce the expenses associated with diagnosis of this disease,” they wrote.
Further evaluation of retinal nerve fiber layer in fibromyalgia sufferers is predicted to enhance the understanding of the disease etiology, and studies with larger sample sizes should detect greater differences between fibromyalgia subgroups.
“Longer-term studies are required to evaluate the clinical application of RNFL measurements in FM patients as 1) a diagnostic tool, 2) to follow disease progression, 3) to identify patients with worse prognosis or at higher risk for loss of quality of life, and 4) to measure treatment effectiveness,” they concluded.
Perhaps in the future, a trip to the ophthalmologist will be part of the diagnostic and disease management strategy for people with fibromyalgia.