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Women with Fibromyalgia Have Thinner Corneal Nerves

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Small fiber neuropathy in women with fibromyalgia. an in vivo assessment using corneal confocal bio-microscopy

Abstract:

Objective: A consistent line of investigation suggests that fibromyalgia is a neuropathic pain syndrome. This outlook has been recently reinforced by several controlled studies which describe decreased small nerve fiber density in skin biopsies of patients with fibromyalgia. The cornea receives the densest small fiber innervation of the body. Corneal confocal bio-microscopy is a new noninvasive method to evaluate small nerve fiber morphology. Our objective was to assess corneal small nerve fiber morphology in patients with fibromyalgia, and to associate corneal nerve microscopic features with neuropathic pain descriptors and other fibromyalgia symptoms.

Methods: We studied 17 female patients with fibromyalgia and 17 age-matched healthy control subjects. All the participants completed different questionnaires in regards to the symptoms of fibromyalgia including a neuropathic pain survey. A central corneal thickness scan was obtained with a confocal microscope. Nerve measurements were made by a single ophthalmologist without knowledge of the clinical diagnosis. Stromal nerve thickness was defined as the mean value between the widest and the narrowest portion of each analyzed stromal nerve. Corneal sub-basal plexus nerve density was also assessed.

Results: Patients with fibromyalgia had stromal nerve thickness of 5.0 ± 1.0 micrometers (mean ± standard deviation) significantly different from control’s values (6.1 ± 1.3) p = 0.01. Patients also had decreased sub-basal plexus nerve density per square millimeter (85 ± 29) vs. 107 ± 26 of controls p = 0.02. When controls and patients were grouped together, there was an association between stromal nerve slenderness and neuropathic pain descriptors (Fischer’s exact test p = 0.007).

Conclusion: Women suffering from fibromyalgia have thinner corneal stromal nerves and diminished sub-basal plexus nerve density when compared to healthy controls. Nerve scarcity is associated with neuropathic pain descriptors. Small fiber neuropathy may play a role in the pathogenesis of fibromyalgia pain. Corneal confocal microscopy could become a useful test in the study of patients with fibromyalgia.

Source: Seminars in Arthritis & Rheumatism, March 21, 2015. By Manuel Ramírez, MD, Laura-Aline Martínez-Martínez, Everardo Hernández-Quintela, MD, Jorge Velazco-Casapía, MD, Angélica Vargas, MD and Manuel Martínez-Lavín, MD. Asociación para Evitar la Ceguera and Instituto Nacional de Cardiología Ignacio Chávez, México.

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6 thoughts on “Women with Fibromyalgia Have Thinner Corneal Nerves”

  1. Fiona63 says:

    In the last few years, as the fibro has gotten worse, I have noticed more and more problems with my eyes. I can’t wear eye make up any more, and I miss it. But it hurts my eyes, and it’s not worth the pain. Also, I have extremely dry eyes and wonder if any of this could be part of what you are discussing in this article. the dryness can be painful and I have to use heavy moisturizing drops several times a day. Since neuropathy was the only symptom discussed, I didn’t know if any of these others went along with this or not. Is there anyway that the opthomologist can see this or test it in an office setting. I have also had narrow angle glaucoma, that has been corrected. Cataracts, the right one has been removed and is very sensitive to light. And I have macular degeneration (dry). any questions or further discussion would be greatly appreciated. I’d love to be the one to help educate the eye doctors in the Memphis area about something new, in an area that some still don’t believe in.

  2. 0135nanaluv says:

    I also have severe dry eyes especially my right eye. I drink a case of water every 5 days. My Optomologist sent me to see a Rheumatologist to see if she could find out why my eyes were so dried that I have blisters in them Have tried several eye drops prescribed by the Dr. & nothing has helped.She thought I may have had Sjogrens Syndrome & had me have a biopsy of my salivary glands which came back negative. So I am back to where I was before with my Optomologist still trying to figure out what is going on with me. My eye huert so much in the morning that I have to wear sunglasses to get use to the light. If not I get extreme sharp pains in my eyes that hurt really bad. I would love to know the answer. He blames it all on my inflammations.

  3. ProHealth-Editor says:

    Last year I, too, began having problems with very dry eyes. It felt like my eyes were scratched and it was quite painful. At the recommendation of my holistic health coach, I started taking fish oil four times a day and the dry eyes are no longer a problem. I take Fisol but I imagine any brand of fish oil would work. I hope that helps. – Karen

  4. booboo2621 says:

    I deal with dry eyes often , and make up does also bother me , but what REALLY is bothering my eyes is my vision itself, it gets so blurry at times I literally just give up looking at anything…..

  5. Andrea139 says:

    I have experienced dry eyes upon waking in am.i have also have had strange eye blurriness, often in one eye for a couple hours.I recently had my eyes examined and he found that I have the beginning of a stigmatizm in my left eye. He said that was rare to have only 1 eye affected.I wonder if any of this is a part of this new rreport.
    Any medical Dr.’s that have any input?
    Thank you for any information.

  6. gentlerain says:

    Is there a researcher who has taken a nerve biopsy and looked at the integrity of the nerves for people who have fibromyalgia? There must be an abnormality with the covering of the nerves or other physical abnormality that could be found when analyzing those nerves. Perhaps there is a virus living in the nerves that is causing so much pain? Look at the amount of pain that Shingles causes. Maybe there is an equivalent situation that causes the pain without creating lesions that are visible externally. I am not aware of anyone microscopically studying the nerves.

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