Peripapillary retina nerve fiber layer thickness and macular ganglion cell layer thickness in patients with obstructive sleep apnea syndrome

Kara, Necip; Sayın, Nihat; Bayramoğlu, Sadık Etka; Savaş, Ayfer Utku

doi:10.1038/eye.2017.279

Cited by 13 publications

(5 citation statements)

References 52 publications

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“…A study conducted by Wang et al40 showed that when AHI values increase, the RNFL gets thinner in all quadrants except temporally. In contrast to our results, studies conducted by Teberik et al23 and Kara et al41 showed that the reduction of RNFLT did not correspond to the OSA severity. Likewise, similar findings were reported in several studies 42,43…”

Section: Discussioncontrasting

confidence: 99%

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%

Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

Devi

Agrawal

Gupta

et al. 2023

Journal of Glaucoma

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“…In a more recent study, it was concluded that the nasal RNFL thickness in patients with OSAS was significantly thinner compared with that of control individuals. By contrast, Nowak et al 16 and Kara et al 17 showed that there was no significant difference in RNFL thickness between patients with OSAS and the control group. Although the superotemporal segments are the regions of the optic disk that are typically first implicated in glaucoma, there were different results for segmental changes in different studies.…”

Section: Discussionmentioning

confidence: 90%

Structural assessment of the optic nerve in patients with obstructive sleep apnea syndrome: Case–control study

Uslu¹,

Kanra

2020

European Journal of Ophthalmology

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Objective Obstructive sleep apnea syndrome has been identified as a possible risk factor for optic nerve pathology such as glaucoma, nonarteritic ischemic optic neuropathy, and optic disk edema. Accordingly, we aimed to evaluate structural changes of the apparently normal optic nerve in obstructive sleep apnea syndrome patients with effects of its severity. Materials and methods In this prospective case–control study, 47 eyes of 47 obstructive sleep apnea syndrome patients diagnosed with polysomnography and 40 eyes of 40 healthy subjects were included. Spectral-domain optical coherence tomography was used to evaluate the peripapillary retinal nerve fiber layer thickness, optic nerve head topographic parameters, and retinal ganglion cell-inner plexiform layer thickness. Results The average peripapillary nerve fiber layer thickness was lower in obstructive sleep apnea syndrome patients than in controls (90.74 ± 7.98 vs 94.93 ± 6.13 μm; p = 0.008). The average cup/disk ratio and the vertical cup/disk ratio in patients with OSAS were significantly higher compared to the controls (both p < 0.001). However, no significant difference in retinal ganglion cell-inner plexiform layer thickness was found. Conclusion Even if the retinal ganglion cell-inner plexiform layer thicknesses did not significantly differ between the obstructive sleep apnea syndrome and control groups, obstructive sleep apnea syndrome patients showed a decreased peripapillary nerve fiber layer thickness and increased optic nerve head parameters. These findings can be used as an indicator of optic nerve damage in the early diagnosis of obstructive sleep apnea syndrome patients.

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“…Additionally, Fan et al 35 described greater progression of structural changes (RNFL thickness) in patients with mild OSA, obtaining an 8.448 risk of structural progression in patients with severe OSA. This differs from the studies of Nowak et al ,24 Salzgeber et al 30 and Kara et al 36. Moreover, Abdullayev et al 37 found no alteration of RNFL thickness in patients with OSA that correlated to its severity but described a decrease in GCC in patients with mild severity.…”

Section: Discussionmentioning

confidence: 65%

Primary open-angle glaucoma in patients with obstructive sleep apnoea in a Colombian population: a cross-sectional study

2023

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ObjectiveDetermine the prevalence, functional and structural alterations of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnoea (OSA).DesignCross-sectional.SettingTertiary hospital associated with specialised center in ophthalmologic images in Bogota, Colombia.Participants150 patients, for a sample of 300 eyes, 64 women (42.7%) and 84 men (57.3%) between 40 and 91 years old with a mean age of 66.8 (±12.1) years.InterventionsVisual acuity, biomicroscopy, intraocular pressure, indirect gonioscopy and direct ophthalmoscopy. Patients classified as glaucoma suspects underwent automated perimetry (AP) and optical coherence tomography of the optic nerveOutcome measureThe primary outcomes are the determination of prevalence of glaucoma suspects and POAG in patients with OSA. Secondary outcomes are the description of functional and structural alterations in computerised exams of patients with OSA.ResultsThe prevalence of glaucoma suspect was 12.6%, and for POAG was 17.3%. No alterations in the appearance of the optic nerve was seen in 74.6%, focal or diffuse thinning of the neuroretinal rim (16.6%) was the most frequently finding, followed by asymmetry of the disc>0.2 mm (8.6%) (p=0.005). In the AP, 41% showed arcuate, nasal step and paracentral focal defects. The mean retinal nerve fiber layer (RNFL) was normal (>80 µM) in 74% of the mild OSA group, 93.8% of the moderate group and 17.1% of the severe group. Similarly, normal (P5-90) ganglion cell complex (GCC) in 60%, 68% and 75%, respectively. Abnormal results in the mean RNFL was seen in 25.9%, 6.3% and 23.4% of the mild, moderate and severe groups, respectively. In the GCC, 39.7%, 33.3% and 25% of the patients in the aforementioned groups.ConclusionIt was possible to determine the relationship between structural changes in the optic nerve and the severity of OSA. No relationship with any of the other studied variables was identified.

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Peripapillary retina nerve fiber layer thickness and macular ganglion cell layer thickness in patients with obstructive sleep apnea syndrome

Cited by 13 publications

References 52 publications

Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

Structural assessment of the optic nerve in patients with obstructive sleep apnea syndrome: Case–control study

Primary open-angle glaucoma in patients with obstructive sleep apnoea in a Colombian population: a cross-sectional study

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