Abstract
Background
In this study, the effects of long-term pregabalin use on the choroid and retinal nerve fiber layer were investigated in the fibromyalgia disease.
Methods
The patient group consisted of 41 fibromyalgia patients using pregabalin. The control group consisted of 41 newly diagnosed fibromyalgia patients who had not received any treatment yet. Choroidal and retinal nerve fiber layer thickness measurements were performed with Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) 30 minutes after pupil dilation with 1% tropicamide.
Results
There was no difference in subfoveal choroidal thickness, nasal choroidal thickness and temporal choroidal thickness between the patient and control groups (p > 0.05). Increasing the duration of drug use within the patient group was found to thin the retinal nerve fiber layer (p < 0.05).
Conclusion
We found that pregabalin had no effect on the choroid, while it had a thinning effect for retinal nerve fiber layer. It is recommended not to be preferred pregabalin in fibromyalgia patients with retinal nerve fiber layer damage such as diabetic retinopathy and glaucoma. Patients treated with pregabalin should have regular control in the ophthalmology clinic.
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References
Häuser W, Fitzcharles MA. Facts and myths pertaining to fibromyalgia. Dialogues Clin Neurosci. 2018;20:53–62.
Marques AP, Santo ASDE, Berssaneti AA, Matsutani LA, Yuan SLK. Prevalence of fibromyalgia: literature review update. Rev Bras Reumatol Engl Ed. 2017;57:356–63.
Arnold LM, Choy E, Clauw DJ, Oka H, Whalen E, Semel D, et al. An evidence-based review of pregabalin for the treatment of fibromyalgia. Curr Med Res Opin. 2018;34:1397–409.
Tsang SH, Sharma T. Drug-induced retinal toxicity. Adv Exp Med Biol. 2018;1085:227–32.
Tanyıldız B, Kandemir B, Mangan MS, Tangılntız A, Göktaş E, Şimşek Ş. Bilateral serous macular detachment after attempted suicide with pregabalin. Turk J Ophthalmol. 2018;48:254–7.
Nickla DL, Wallman J. The multifunctional choroid. Prog Retin Eye Res. 2010;29:144–68.
Yıldırım G, Şahlı E, Alp MN. Evaluation of the Effect of Proptosis on Choroidal Thickness in Graves’ Ophthalmopathy. Turk J Ophthalmol. 2020;50:221–7.
Kalenderoglu A, Orum MH, Karadag AS, Kustepe A, Celik M, Egilmez OB, et al. Increases in retinal nerve fiber layer thickness may represent the neuroprotective effect of cannabis: an optical coherence tomography study. J Addict Dis. 2020;38:280–90.
Huang J, Zhou L, Wang H, Luo J, Zeng L, Xiong K, et al. Distribution of thrombospondins and their neuronal receptor α2δ1 in the rat retina. Exp Eye Res. 2013;111:36–49.
Kavoussi R. Pregabalin: From molecule to medicine. Eur Neuropsychopharmacol. 2006;16:S128–33. Suppl 2
White AT, Light KC, Bateman L, Hughen RW, Vanhaitsma TA, Light AR. Effect of pregabalin on cardiovascular responses to exercise and postexercise pain and fatigue in fibromyalgia: a randomized, double-blind, crossover pilot study. Pain Res Treat. 2015;2015:136409.
Parveen S, Negi DS, Kumar R, Bagwan MC. Oral clonidine vs oral pregabalin premedication to attenuate pressor response to direct laryngoscopy in patients undergoing laparoscopic cholecystectomy: a randomized double blind study. J Clin Diagn Res. 2016;10:UC21–UC25.
Kur J, Newman EA, Chan-Ling T. Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease. Prog Retin Eye Res. 2012;31:377–406.
Toledo CA, Reiner A, Patel RS, Vitale AW, Klein JM, Dalsania BJ, et al. Immunohistochemical localization of AMPA-type glutamate receptor subunits in the nucleus of the Edinger-Westphal in embryonic chick. Neurosci Lett. 2011;498:199–203.
Cuthbertson S, White J, Fitzgerald ME, Shih YF, Reiner A. Distribution within the choroid of cholinergic nerve fibers from the ciliary ganglion in pigeons. Vis Res. 1996;36:775–86.
de Hoz R, Ramírez AI, Salazar JJ, Rojas B, Ramírez JM, Triviño A. Substance P and calcitonin gene-related peptide intrinsic choroidal neurons in human choroidal whole-mounts. Histol Histopathol. 2008;23:1249–58.
Lee EJ, Kim SJ, Han JC, Eo DR, Lee MG, Ham DI, et al. Peripapillary retinal nerve fiber layer thicknesses did not change in long-term hydroxychloroquine users. Korean J Ophthalmol. 2018;32:459–69.
Jin KW, Lee JY, Rhiu S, Choi DG. Longitudinal evaluation of visual function and structure for detection of subclinical Ethambutol-induced optic neuropathy. PLoS One. 2019;14:e0215297.
Moseng L, Sæter M, Mørch-Johnsen GH, Hoff JM, Gajda A, Brodtkorb E, et al. Retinal nerve fiber layer attenuation: clinical indicator for vigabatrin toxicity. Acta Ophthalmol. 2011;89:452–8.
Ali SA, Zaitone SA, Dessouki AA, Ali AA. Pregabalin affords retinal neuroprotection in diabetic rats: Suppression of retinal glutamate, microglia cell expression and apoptotic cell death. Exp Eye Res. 2019;184:78–90.
Chintalapudi SR, Maria D, Di Wang X, Bailey JNC. NEIGHBORHOOD consortium; International Glaucoma Genetics consortium, et al. Systems genetics identifies a role for Cacna2d1 regulation in elevated intraocular pressure and glaucoma susceptibility. Nat Commun. 2017;8:1755.
Ibrahim MM, Maria DN, Mishra SR, Guragain D, Wang X, Jablonski MM. Once daily pregabalin eye drops for management of glaucoma. ACS Nano. 2019;13:13728–44.
Moriya S, Hasegawa M, Inamasu J, Kogame H, Hirose Y, Higashi R, et al. Neuroprotective effects of pregabalin in a rat model of intracisternal facial nerve avulsion. J Neurosurg Sci. 2017;61:495–503.
Taha SHN, Zaghloul HS, Ali AAER, Gaballah IF, Rashed LA, Aboulhoda BE. The neurotoxic effect of long-term use of high-dose Pregabalin and the role of alpha tocopherol in amelioration: implication of MAPK signaling with oxidative stress and apoptosis. Naunyn Schmiedebergs Arch Pharmacol. 2020;393:1635–48.
Elgazzar FM, Elseady WS, Hafez AS. Neurotoxic effects of pregabalin dependence on the brain frontal cortex in adult male albino rats. Neurotoxicology. 2021;83:146–55.
Kamel MA. Study on DNA damage and oxidative stress and some biochemical alterations of long term administration of alpha-2 delta (Α2-Δ) ligand pregabalin and the possibility of Zingiber officinale in ameliorating these effects in rats. World J Pharm Res. 2016;5:1528–45.
Ninomiya W, Mizobuchi K, Hayashi T, Okude S, Katagiri S, Kubo A, et al. Electroretinographic abnormalities associated with pregabalin: a case report. Doc Ophthalmol. 2020;140:279–87.
Secinti IE. Retinal teratogenicity of pregabalin in chick embryo model. Cutan Ocul Toxicol. 2020;39:304–10.
Ulusoy MO, Kal A, Işik-Ulusoy S, Kal Ö. Choroidal thickness in patients with fibromyalgia and correlation with disease severity. Indian J Ophthalmol. 2018;66:428–32.
Garcia-Martin E, Garcia-Campayo J, Puebla-Guedea M, Ascaso FJ, Roca M, Gutierrez-Ruiz F, et al. Fibromyalgia is correlated with retinal nerve fiber layer thinning. PLoS One. 2016;11:e0161574.
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GYB was responsible for the study design, data collection and analysis, writing of the. manuscript and creation of the figures. KRZ and KEB were responsible for parts of the data collection. EK and EBK were responsible for manuscript review. The final version was of the manuscript was approved by all authors.
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Biçer, G.Y., Zor, K.R., Biçer, K.E. et al. Can the long term using of pregabalin in fibromyalgia affect the choroid and retinal nerve fiber layer?. Eye 36, 2318–2322 (2022). https://doi.org/10.1038/s41433-021-01864-9
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DOI: https://doi.org/10.1038/s41433-021-01864-9
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