Evaluation of retinal fiber thickness and visual pathways with optic coherence tomography and pattern visual evoked potential in different clinical stages of obstructive sleep apnea syndrome

Ak, Ayşın Kısabay; Göktalay, Tuğba; Mayalı, Hüseyin; Kurt, Emin; Selçuki, Deniz; Yılmaz, Hikmet

doi:10.1007/s10633-020-09749-0

Cited by 6 publications

(7 citation statements)

References 43 publications

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“…Our findings were consistent with the findings of studies conducted by Huseyinoglu et al, 6 Lin et al, 11 Wang et al, 19 and Zengin et al, 20 who showed a statistically significant difference in the average RNFLT between the 3 OSA groups. Contrary to our findings, some studies [21][22][23][24][25][26] showed no significant difference in average RNFLT among OSA subgroups.…”

Section: Discussioncontrasting

confidence: 99%

“…Our findings were consistent with the findings of several studies 6,8,28,31,37 including meta-analyses 38,39 that showed a significant negative correlation between AHI and RNFLT. Lin et al 11 and Ngoo et al 31 in their studies, found a negative correlation between AHI and RNFLT in the superior and nasal quadrants and Shiba et al 5 found a negative correlation only in the nasal quadrant and Kisabay et al 26 found a negative correlation in inferior and nasal quadrants. A study conducted by Wang et al 40 showed that when AHI values increase, the RNFL gets thinner in all quadrants except temporally.…”

Section: Discussionmentioning

confidence: 90%

“…Kargi et al,8 and Sun et al28 found that RNFLT in superior and inferior quadrants was more sensitive than in other quadrants in OSA disease by subgroup analysis. But, Shiba et al,5 Kisabay et al,26 and Casas et al29 showed a significant difference in RNFLT only in nasal quadrants between OSA subgroups. Our findings were in contrast to the findings of Ferrandez et al,21 Guven et al,23 and Adam et al,24 who found no differences in RNFLT in any of the 4 quadrants between the OSA subgroups.…”

Section: Discussionmentioning

confidence: 94%

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Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

Devi

Agrawal

Gupta

et al. 2023

Journal of Glaucoma

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Précis: Average and superior quadrant retinal nerve fiber layer thickness (RNFLT) was lower in the more severe obstructive sleep apnea (OSA) group and inversely associated with apnea-hypopnea index (AHI). OSA may have an impact on RNFLT.Purpose: The purpose of this study was to study the RNFLT using optical coherence tomography (OCT) in patients with different severities of OSA.Patients and Methods: In this hospital-based prospective crosssectional study, 90 (90 eyes) newly diagnosed OSA patients aged 18 years or above were enrolled. Based on the AHI, there were 38.8%, 30%, and 31.1% cases of mild (AHI ≥ 5 to <15), moderate (AHI ≥ 15 to <30), and severe (AHI ≥ 30) OSA, respectively. All the participants underwent a comprehensive ocular examination. OCT was done using CIRRUS HD-OCT 500 to measure the RNFLT. Results:The average RNFLT among the 3 OSA groups was significantly different (P = 0.002) and inversely associated with AHI (P = 0.02, r s = −0.16). Severe OSA had thinner average RNFLT than those with mild and moderate OSA (P = 0.01 and 0.003, respectively). Among the 4 quadrants observed, only the superior quadrant RNFLT among the 3 OSA groups was significantly different (P < 0.00001) and inversely associated with AHI (P = 0.01, r s = −0.17). Severe OSA had thinner superior quadrant RNFLT than those with moderate OSA (P < 0.01). The differences in the intraocular pressure among the 3 OSA groups were statistically significant (P < 0.0008). Patients with moderate and severe OSA had higher intraocular pressure than patients with mild OSA (P = 0.002 and 0.001, respectively).Conclusions: Attention should be paid to the patients with OSA as it may have an impact on RNFLT. OSA patients should be screened for glaucoma as early detection of glaucoma can reduce vision loss in these patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 94%

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Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

Devi

Agrawal

Gupta

et al. 2023

Journal of Glaucoma

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“…Fan et al (2019) also reported that severe OSA is significantly associated with the progressive decrease in RNFL thickness in patients with glaucoma. Furthermore, several studies had found that retinal thickness is decreased in patients with different severities of OSA (Casas et al, 2018;Kısabay Ak et al, 2020;Naranjo-Bonilla et al, 2021). However, obtaining an accurate diagnosis of OSA is sometimes difficult.…”

Section: Discussionmentioning

confidence: 99%

Association of self-reported snoring with decreased retinal thickness and vessel density

Xiao

Shi

et al. 2022

Front. Physiol.

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Purpose: Self-reported snoring has been reported to influence nerves and vessels. However, there are few direct evidences of snoring related to nerves and microvessels defects. Therefore, we evaluated the association of self-reported snoring with retinal structure and microcirculation.Methods: A total of 2,622 participants were recruited from the Jidong eye cohort study (JECS). Physical examinations, laboratory tests, and questionnaires were recorded. We also used optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) to assess the retinal structure and microvascular network. Snoring was defined as “never,” “occasionally,” and “frequently or more severe” according to self-reported frequency.Results: The prevalence of snoring were 84.6% (n = 983) and 45.0% (n = 657) in males and females, respectively. Compared with never snoring group, the retinal thickness increased in “occasionally” (p < 0.001) and “frequently or more severe” groups (p = 0.001), while no difference was found between snoring groups (p = 0.14). Superficial retinal capillary plexus (RCP) vessel density was lower in “frequently or more severe” group than in “never” (p < 0.001) and “occasionally” snoring groups (p < 0.001). After adjusting for confounders, “frequently or more severe” snoring was significantly associated with thinner total retinal thickness [β = −2.79 (95% CI: −5.27, −0.30)] and lower superficial RCP vessel density [β = −0.71 (95% CI: −1.19, −0.23)].Conclusion: Our research showed self-reported snoring was associated with thinner retinal thickness and lower superficial RCP vessel density. The findings of our study emphasize the need for self-reported snoring assessments in determining retinal structure and microcirculation impairment.

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“…Anatomically, a thinner retinal nerve fiber layer (RNFL) [ 38 , 39 , 40 ], lower ganglion cell complex thickness [ 41 , 42 ], lower peripapillary vessel density, and increased foveal avascular zone in optical coherence tomography angiography [ 43 , 44 ] are all reported in patients with greater OSA severity. Functionally, a higher incidence of visual field defects, which correlate with AHI in NTG [ 45 ], as well as an amplitude reduction and longer latency period in visual evoked potential (VEP), has been reported [ 46 , 47 ].…”

Section: Osa-associated Complications In Optic Nervementioning

confidence: 99%

Ocular Complications of Obstructive Sleep Apnea

Liu

Chiu

Wang

et al. 2021

JCM

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Obstructive sleep apnea (OSA), the most common form of sleep-disordered breathing, is characterized by repetitive episodes of paused breathing during sleep, which in turn induces transient nocturnal hypoxia and hypercapnia. The high prevalence of OSA and its associated health consequences place a heavy burden on the healthcare system. In particular, the consequent episodic oxygenic desaturation/reoxygenation series and arousals from sleep in patients with OSA have the potential to trigger oxidative stress, elevated systemic inflammatory responses, and autonomic dysfunction with sympathetic activation. Given these adverse side-effects, OSA is highly correlated to many eye diseases that are common in everyday ophthalmic practices. Some of these ocular consequences are reversible, but they may permanently threaten a patient’s vision if not treated appropriately. Here, this article seeks to review the ocular consequences and potential pathophysiologic associations in patients with OSA. Understanding these OSA-related eye diseases may help clinicians provide comprehensive care to their patients.

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Evaluation of retinal fiber thickness and visual pathways with optic coherence tomography and pattern visual evoked potential in different clinical stages of obstructive sleep apnea syndrome

Cited by 6 publications

References 43 publications

Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

Association of self-reported snoring with decreased retinal thickness and vessel density

Ocular Complications of Obstructive Sleep Apnea

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