Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome

Lin, Pei‐Wen; Friedman, Michael; Lin, Hsin‐Ching; Chang, Hsueh‐Wen; Pulver, Tanya; Chin, Chien-Hung

doi:10.1007/s00417-010-1544-1

Cited by 93 publications

(101 citation statements)

References 33 publications

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“…Additionally, ocular diseases such as glaucoma usually accompany OSAS (10,19) . The effects of OSAS on posterior ocular tissues have been investigated in several studies (11)(12)(13)(14) . In a study which investigated the diff erences in choroidal and RNFL thickness, the control group was compared with mild, moderate, and severe OSAS groups (12) .…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of posterior ocular changes using enhanced depth imaging-optical coherence tomography in patients with obstructive sleep apnea syndrome

Yuvacı

Pangal

Bayram

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Obstructive Sleep Apnea Syndrome (OSAS), which is the complete or partial obstruction of the upper airways recurrently during sleep, is fairly common, at rates of 3%-7% in the population (1,2) . Resultant hy percapnia and re-oxygenation cause humoral and vascular changes by modifying several blood parameters such as lowering of pH, increasing of nitric oxide (NO), and vasodilatation caused by hypoxia. Consequently, changes occur in the balance between vasodilatation and vasoconstriction in blood vessels. Additionally, hypercapnia causes an increase in tonus by causing systemic autonomic dysfunction. Eventually, apnea and hypopnea contribute to the development ABSTRACT Purpose: Evaluation of the nerve fiber thicknesses of the macula, choroid, and retina using the apnea-hypopnea index in individuals with obstructive sleep apnea syndrome (OSAS) without systemic components. Methods: Prospective, controlled study. The central macular, choroidal, and retinal nerve fiber layer (RNFL) thicknesses were evaluated using enhanced depth imaging-spectral domain optical coherence tomography in individuals with OSAS. In people with severe OSAS who had received treatment, posterior ocular structures were examined over 3 months (4 th and 12 th weeks), and changes were evaluated. Only the right eyes of the participants were evaluated in the study. Results: A total of 72 people were involved in the study, with 18 in the control group and 19 with mild, 16 with moderate, and 19 with severe OSAS. No significant difference was found among the groups in terms of demographic measures. No significant differences were found among the groups in terms of the measures of central macular, central subfoveal choroidal (CSCT), temporal choroidal, nasal choroidal, and RNFL thicknesses. In severe OSAS cases in which treatment was administered, although subjective clinical recovery was observed, statistically significant thinning was detected during the 3-month follow-up period in the CSCT, general RNFL, as well as in the inferior and superior nasal quadrants, and temporal superior quadrant (p=0. 005, p=0.009, p=0.039, p=0.003, and p=0.02, respectively). Conclusion: In the group with severe OSAS, thinning in some posterior ocular tissues was observed. Although patients with severe OSAS may experience clinical recovery, we recommend that they would be followed up in terms of ocular ischemic injury. Keywords

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Section: Discussionmentioning

confidence: 99%

“…Hypercapnia-hypoxia that occurs at night because of the disease can cause injury in the head of the optic nerve, which is extremely sensitive to hypoxia, and ganglion cells (10,11) . Glaucoma is more commonly seen in individuals with the disease (10) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of posterior ocular changes using enhanced depth imaging-optical coherence tomography in patients with obstructive sleep apnea syndrome

Yuvacı

Pangal

Bayram

et al. 2016

Arquivos Brasileiros De Oftalmologia

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“…In patients with central serous chorioretinopathy, EDI-OCT has demonstrated an association with a thicker subfoveal choroidal layer (7) . In addition, an association between a diagnosis of OSAHS and an increased risk of open angle glaucoma has previously been demonstrated (26) , and it has also been shown that RNFL thickness is reduced in OSAHS patients, even though there are no visual field defects (27) . Also, the subclinical progression of ischemic optic neuropathy may be associated with choroidal layer pathology.…”

Section: Discussionmentioning

confidence: 93%

Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome

Kara¹,

Özçimen²,

Bekçi³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by transient upper airway resistance caused by a recurrent reduction or cessation of airflow, due to partial or complete occlusion of the upper airway during sleep. It is associated with sleep fragmentation, arousals, bradycardia, tachycardia, and inadequate oxygen saturation despite an increased respiratory effort (1) . Major clinical consequences of the disorder include excessive daytime sleepiness, neurocognitive dysfunction, cardiovascular diseases (hypertension, ABSTRACTPurpose: To compare the subfoveal choroidal thickness (SFCT) of patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) and normal controls via enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this retrospective, case-control study, 49 eyes from 49 patients that had undergone polysomnography were included. SFCT of the horizontal and vertical line scans were manually measured for all eyes based on EDI-OCT images. Two separate analyses were performed according to different apnea/hypopnea index (AHI) groupings. Initial testing was conducted using non-OSAHS, mild OSAHS (5≤AHI<15), moderate OSAHS (15≤AHI<30), and severe OSAHS (AHI≥30) patient groupings, while secondary testing used non-OSAHS, mild OSAHS (5≤AHI<15), and moderate/severe OSAHS (AHI≥15) patient groupings. Results: The mean SFCT was 314.5 µm in the non-OSAHS patients (n=14), 324.5 µm in the mild OSAHS patients (n=15), 269.3 µm in the moderate OSAHS patients (n=11), and 264.3 µm in the severe OSAHS patients (n=9). SFCT between the four groups revealed no significant differences despite a trend towards slight thinning in the severe group (P=0.08). When the moderate and severe groups were merged and compared with the mild OASHS and non-OSAHS groups, SFCT of the moderate/severe group was found to be significantly thinner than that of the mild group (P=0.016). A negative significant correlation was found between SFCT and AHI in OSAHS patients (r=0.368, P=0.033). Conclusions:In patients with moderate/severe OSAHS, EDI-OCT revealed a thinned SFCT. Other accompanying systemic or ocular diseases may induce perfusion and oxygenation deficiency in eyes of OSAHS patients. Further studies are required in order to determine the exact relationships between ocular pathologies and clinical grades of OSAHS. Keywords

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“…Several systematic studies are necessary to explicate fully the nature of those relationships. Clinical studies typically show that sleep apnea is associated with several glaucoma indices including intraocular pressure, visual field mean deviation, cup-to-disk ratios, and retinal nerve fiber layer thickness [68][69][70]. Additionally, evidence from a treatment study using ocular oxymetry recording, a novel tool utilized to measure ocular oxygen tension [71], suggests an association between finger blood flow and optic nerve head blood flow among patients with glaucoma.…”

Section: Complex Relationships Between Sleep Apnea and Glaucomamentioning

confidence: 99%

“…The first line of study showed that retinal nerve fiber layer is thinner among patients with sleep apnea [69,76,77], which parenthetically generated the hypothesis that reduced ocular perfusion related to hypoxia and vasospasm observed in sleep apnea may cause nerve fiber layer thinning. The second line of investigation showed that retinal nerve fiber layer is typically thinner among Black patients [78].…”

Section: Complex Relationships Between Sleep Apnea and Glaucomamentioning

confidence: 99%

Sleep Apnea and Glaucoma – Greater Risk for Blacks?

Zizi¹,

Mallick²,

Dweck³

et al. 2011

Glaucoma - Basic and Clinical Concepts

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Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome

Cited by 93 publications

References 33 publications

Evaluation of posterior ocular changes using enhanced depth imaging-optical coherence tomography in patients with obstructive sleep apnea syndrome

Evaluation of posterior ocular changes using enhanced depth imaging-optical coherence tomography in patients with obstructive sleep apnea syndrome

Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome

Sleep Apnea and Glaucoma – Greater Risk for Blacks?

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