Frequency of fibromyalgia syndrome in patients with central serous chorioretinopathy
Arquivos Brasileiros de Oftalmologia
Central serous chorioretinopathy (CSCR) is a common maculopathy that involves serous detachment of the neurosensory retina associated with focal lesions in the retinal pigment epithelium and with circulatory disturbances of choroidal vasculature (1) . Although its etiopathogenesis is not fully understood, many precipitating factors have been revealed, including smoking, stress, pregnancy, hypercortisolemia, and inoculation. Stress and the type A personality trait are the best known risk
... known risk factors. It has also been proposed that emotional conditions in combination with smoking can cause angiospasm (2) . In general, individuals with CSCR are otherwise healthy. Fibromyalgia syndrome (FMS) is a condition characterized by chronic, diffuse musculoskeletal pain and tenderness (3, 4) . It affects almost all races, ethnicities, socioeconomic classes, and age groups, including children. It is more common among woman; the female-to-male ratio is 9:1 (3) . Its prevalence in developed countries has been reported as 0.5%-4% (5) . The incidence increases with age, and it is most frequently ABSTRACT Purpose: To ınvestigate frequency of fibromyalgia syndrome (FMS) among patients with central serous chorioretinopathy (CSCR). Methods: The study included 83 patients with CSCR and 201 age-and sex-matched healthy controls; the mean age was 47.5 ± 11.3 years in the CSCR group (18 women; 21.7%) and 47.2 ± 11.2 years in the control group (44 women; 21.9%). All participants were assessed for FMS based on 2010 American College of Rheumatology diagnostic criteria and for depression and anxiety with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Results: FMS was diagnosed in 35 patients (42.2%) from the CSCR group and in 21 individuals (10.4%) from the control group (p<0.001). It was found in 77.77% of the women (14/18) and 32.3% of the men (21/65) in the CSCR group and in 22.7% of the women (10/44) and 7.0% of the men (11/157) in the control group. Familial stress, BDI and BAI scores were higher in the patients with FMS than in those without. When independent risk factors were evaluated by logistic regression analysis, it was found that only the presence of familial stress was a significant risk factor for FMS. Conclusions: Patients with CSCR should be assessed for the presence of FMS, and this should be taken into consideration when developing a treatment plan. Further studies with a larger sample size are needed to clarify the relationship between FMS and CSCR. RESUMO Objetivo: Investigar a frequência da fibromialgia (FMS) entre os pacientes com co riorretinopatia serosa central (CSCR). Métodos: O estudo incluiu 83 pacientes com CSCR e 201 controles saudáveis parea dos por idade e sexo. Todos os participantes foram avaliados com base nos critérios de diagnóstico de FMS do American College of Rheumatology de 2010 (ACR), Beck Anxiety Inventory (BAI) e Beck Depression Inventory (BDI). Resultados: A idade média foi 47,53 ± 11,33 anos no grupo CSCR (18 mulheres; 21,7%) e 47,19 ± 11,19 anos (44 mulheres; 21,9%) no grupo controle. FMS foi diagnosticada em 35 pacientes (42,2%) do grupo CSCR e em 21 indivíduos (10,4%) do grupo controle (p<0,001). FMS foi encontrado em 77,77% das mulheres (14/18) e 32,3% dos homens (21/65) no grupo CSCR e em 22,7% das mulheres controles (10/44) e 7,0% dos homens controles (11/157). Estresse familiar, BDI e BAI foram maiores nos pacientes com FMS em comparação com aqueles sem FMS. Quando os fatores de risco independentes foram avaliados por análise de regressão logística, verificouse que apenas a presença de estresse familiar foi um fator de risco significativo para FMS. Conclusões: Os pacientes com CSCR devem ser avaliados para presença de FMS e a FMS deve ser levada em consideração durante o desenvolvimento de um plano de tratamento. São necessários mais estudos com maior tamanho da amostra para esclarecer relações entre FMS e CSCR. Descritores: Coriorretinopatia serosa central; Fibromialgia; Doenças da coroide; Epi télio pigmentado ocular/patologia; Doenças retinianas Approved by the following research ethics committee: Antalya Training and Research Hospital (#2015177). Parameter Value BMI, kg/m 2 26.62 ± 04.05 Smoking status Non-smoker, n (%) 33 (39.8) Ex-smoker, n (%) 23 (27.7) Current smoker, n (%) 27 (32.5) Amount smoked, packs per year 12.70 ± 14.78 Marital status Single, n (%) 16 (19.3) Married, n (%) 67 (80.7) Partner Yes, n (%) 72 (86.7) No, n (%) 11 (13.3) Work stress Yes, n (%) 38 (45.8) No, n (%) 45 (54.2) Familial stress Yes, n (%) 30 (36.1) No, n (%) 53 (63.9) Disease duration, mo 18.82 ± 16.59 Disease type Acute, n (%) 23 (28.4) Chronic, n (%) 58 (71.6) GERD Yes, n (%) 23 (27.7) No, n (%) 60 (72.3) BMI= body mass index; GERD= gastroesophageal reflux disease.