Association between dry eye, ophthalmic structures and fibromyalgia syndrome

Tear break up time was significantly lower in patients with fibromyalgia, the study's authors found. Image credit: ©peopleimages.com – stock.adobe.com

A new Turkish study found “a relationship between dry eye, vascular changes and increased choroidal thickness with disease severity in female patients with fibromyalgia syndrome,” compared with healthy controls,¹ according to first author Gülşah Çelik, MD, and colleagues. She is from the Department of Physical Medicine and Rehabilitation, Antalya City Hospital, Antalya, Turkey.

The participants in the study, which was conducted from January to October 2022, were 62 women with fibromyalgia syndrome and 60 healthy controls. The investigators evaluated the tear production and stability using the Schirmer and tear break-up time (TBUT) tests. Optical coherence tomography (OCT) and OCT angiography (OCTA) were performed to evaluate the vascular and choroidal structures.

Findings associated with fibromyalgia

The mean patient age was 43.11 ± 7.94 years.

The investigators found no significant difference in the results of the Schirmer tests between the patients and controls, but the TBUT was significantly lower in the fibromyalgia group (P < 0.001).

Imaging demonstrated the structural differences in the patients. OCTA showed significantly lower deep capillary plexus (DCP) values in the fibromyalgia group, with a weak negative correlation between DCP and disease severity (r = −0.227, P = 0.012). The foveal avascular zone (FAZ) non-flow, and choroidal thickness were significantly higher in the patients with fibromyalgia (P < 0.050), the authors reported.

“The study demonstrated a relationship between dry eye, vascular changes, and increased choroidal thickness with disease severity in female patients with fibromyalgia syndrome,” they commented.

They theorised that the reduction in the DCP values, along with the increases in the FAZ, non-flow and choroidal thickness, may be associated with the vascular and inflammatory processes involved in the pathogenesis of the fibromyalgia syndrome. In addition, they suggested that the decreased tear quality they observed may be due to autonomic nervous system dysfunction.

“In conclusion, we suggest that autonomic dysfunction and inflammation in the fibromyalgia syndrome may negatively affect retinal vascular structures and tear function,” they said.

Reference

Çelik G, Koldaş Doğan Ş, Bulut M, Hakan Büber, Doğan Durmaz. Evaluation of ophthalmic vascular and neural structures in female patients with fibromyalgia syndrome and their relationship with disease severity. Int Ophthalmol. 2025;45:123. https://doi.org/10.1007/s10792-025-03497-3