OCT/OCTA Findings Reveal Neuroretinal Alterations in Fibromyalgia Patients

Turkish researchers have highlighted the role of optical coherence tomography (OCT) and OCT angiography (OCTA) in detecting neuroretinal changes in patients with fibromyalgia. These imaging techniques offer objective supplementary measurements of key ocular structures, including the retinal nerve fiber layer (RNFL), macular ganglion cell layer (GCL), and circumpapillary vessel density (cpVD).

The study, led by Tuğba Aydoğan Gezginaslan, MD, and her colleagues from the Eye Clinic, University of Health Sciences Umraniye Training and Research Hospital in Istanbul, Turkey, provides valuable insights into the neuroretinal effects of fibromyalgia.

Study Overview

Participants

       • 44 patients with fibromyalgia.

       • 40 healthy controls for comparison.

Methods

The researchers utilized OCT and OCTA to measure:

       • Superficial vessel density (SVD)

       • Deep vessel density (DVD)

       • Foveal avascular zone (FAZ)

       • Circumpapillary vessel density (cpVD)

Additionally, all fibromyalgia patients completed:

       • The Fibromyalgia Impact Questionnaire

       • Short Form-36

       • Widespread Pain Index

       • Symptom Severity Scale

The correlations between the questionnaire results and OCT/OCTA findings were analyzed.

Key Findings

The study revealed significant differences in neuroretinal structures between fibromyalgia patients and healthy controls:

Retinal Thickness

       • Fibromyalgia patients exhibited lower macular thickness values in multiple regions, including:

               - Parafoveal (nasal, temporal, superior, inferior).

               - Perifoveal (temporal, superior).

               - GCL+ (parafoveal nasal, temporal, superior, inferior).

               - GCL++ (parafoveal nasal, temporal, superior, inferior).

Retinal Layers Explained

       • GCL+ includes the GCL and inner plexiform layer (IPL).

       • GCL++ includes the GCL, IPL, and macular RNFL.

RNFL and cpVD

       • RNFL thickness in the temporal area was lower in fibromyalgia patients.

       • cpVD in the nasal, superior, and inferior regions was higher in fibromyalgia patients.

       • Logistic regression analysis identified an association between superior cpVD and fibromyalgia.

Other Parameters

       • No significant differences were observed in SVD, DVD, or FAZ measurements.

       • Weak correlations were found between the questionnaire results and OCT/OCTA parameters.

Conclusion

The findings underscore the value of OCT and OCTA in assessing neuroretinal changes in fibromyalgia patients. The authors concluded:

“OCT/OCTA can provide objective supplementary measurements in the assessment of FM. Changes in measurements such as the RNFL, macula GCL, and cpVD are important to evaluate the neuroretinal changes in FM.”

Implications for Ophthalmology

This study demonstrates the potential for ophthalmic imaging to play a role in understanding and managing the systemic effects of fibromyalgia, offering new pathways for diagnosis and monitoring in patients with this condition.

Reference:

Gezginaslan TA, Limon U, Kaleoğlu Ö, et al. Evaluation of optical coherence tomography and optical coherence tomography angiography findings of fibromyalgia. Int Ophthalmol. 2025;45; https://doi.org/10.1007/s10792-024-03363-8