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      Frequency of fibromyalgia syndrome in patients with central serous chorioretinopathy Translated title: Frequência de síndrome de fibromialgia em pacientes com coriorretinopatia serosa central

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          Abstract

          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.

          Translated abstract

          RESUMO Objetivo: Investigar a frequência da fibromialgia (FMS) entre os pacientes com coriorretinopatia serosa central (CSCR). Métodos: O estudo incluiu 83 pacientes com CSCR e 201 controles saudáveis pareados 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, verificou-se 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.

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          A new view on hypocortisolism.

          Low cortisol levels have been observed in patients with different stress-related disorders such as chronic fatigue syndrome, fibromyalgia, and post-traumatic stress disorder. Data suggest that these disorders are characterized by a symptom triad of enhanced stress sensitivity, pain, and fatigue. This overview will present data on the development, mechanisms and consequences of hypocortisolism on different bodily systems. We propose that the phenomenon of hypocortisolism may occur after a prolonged period of hyperactivity of the hypothalamic-pituitary-adrenal axis due to chronic stress as illustrated in an animal model. Further evidence suggests that despite symptoms such as pain, fatigue and high stress sensitivity, hypocortisolism may also have beneficial effects on the organism. This assumption will be underlined by some studies suggesting protective effects of hypocortisolism for the individual.
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            The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties

            Introduction The Fibromyalgia Impact Questionnaire (FIQ) is a commonly used instrument in the evaluation of fibromyalgia (FM) patients. Over the last 18 years, since the publication of the original FIQ, several deficiencies have become apparent and the cumbersome scoring algorithm has been a barrier to widespread clinical use. The aim of this paper is to describe and validate a revised version of the FIQ: the FIQR. Methods The FIQR was developed in response to known deficiencies of the FIQ with the help of a patient focus group. The FIQR has the same 3 domains as the FIQ (that is, function, overall impact and symptoms). It differs from the FIQ in having modified function questions and the inclusion of questions on memory, tenderness, balance and environmental sensitivity. All questions are graded on a 0–10 numeric scale. The FIQR was administered online and the results were compared to the same patient's online responses to the 36-Item Short Form Health Survey (SF-36) and the original FIQ. Results The FIQR was completed online by 202 FM patients, 51 rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) patients (31 RA and 20 SLE), 11 patients with major depressive disorder (MDD) and 213 healthy controls (HC). The mean total FIQR score was 56.6 ± 19.9 compared to a total FIQ score of 60.6 ± 17.8 (P < 0.03). The total scores of the FIQR and FIQ were closely correlated (r = 0.88, P < 0.001). Each of the 3 domains of the FIQR correlated well with the 3 related FIQ domains (r = 0.69 to 0.88, P < 0.01). The FIQR showed good correlation with comparable domains in the SF-36, with a multiple regression analysis showing that the three FIQR domain scores predicted the 8 SF-36 subscale scores. The FIQR had good discriminant ability between FM and the 3 other groups; total FIQR scores were HC (12.1 ± 11.6), RA/SLE (28.6 ± 21.2) and MDD (17.3 ± 11.8). The patient completion time was 1.3 minutes; scoring took about 1 minute. Conclusions The FIQR is an updated version of the FIQ that has good psychometric properties, can be completed in less than 2 minutes and is easy to score. It has scoring characteristics comparable to the original FIQ, making it possible to compare past FIQ results with future FIQR results.
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              Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy.

              To investigate factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy (ICSC). Retrospective consecutive case series that included patients with ICSC who were younger than 50 years of age at the time of initial examination and were followed up for > or =3 years. The mean follow-up for 101 involved eyes of 61 patients was 9.8 years (median, 8.0 years). Eyes were stratified into two groups based on visual acuity at the final examination: Group 1, visual acuity of 2040 or better; and Group 2, visual acuity of worse than 2040. Findings identified as potential risk factors for reduced vision at the final follow-up examinations for Group 1 versus Group 2 included the following: macular retinal pigment epithelium atrophy (90.8% versus 96.0%, respectively; P = 0.68); persistent pigment epithelial detachment or persistent subretinal fluid (5.3% versus 28.0%, respectively; P = 0.004); recurrences (39.5% versus 68.0%, respectively; P = 0.020); laser treatment (28.9% versus 32.0%, respectively; P = 0.80); and submacular choroidal neovascularization (0.0 versus 8.0%, respectively; P = 0.059). Factors associated with reduced visual acuity during long-term follow-up of patients with ICSC included persistent pigment epithelial detachment and/or subretinal fluid, recurrences, and submacular choroidal neovascularization.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                0004-2749
                1678-2925
                January 2017
                : 80
                : 1
                : 4-8
                Affiliations
                [2] Antalya orgnameAntalya Training and Research Hospital orgdiv1Ophthalmology Department Turkey
                [1] Antalya orgnameAntalya Training and Research Hospital orgdiv1Rheumatology Department Turkey
                [3] Antalya orgnameAkdeniz University orgdiv1Medical Faculty orgdiv2Ophthalmology Department Turkey
                Article
                S0004-27492017000100003
                10.5935/0004-2749.20170003
                ecd62e50-0beb-462b-a67b-1b22021130c0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 10 May 2016
                : 22 September 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 5
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                SciELO Brazil


                Pigment epithelium of eye/pathology,Retinal diseases,Coriorretinopatia serosa central,Fibromialgia,Doenças da coroide,Epitélio pigmentado ocular/patologia,Doenças retinianas,Central serous chorioretinopathy,Fibromyalgia,Choroid diseases

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