Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months

Abstract

Background: To determine the impacts of continuous positive airway pressure (CPAP) treatment on retinal and choroidal thickness measurement in individuals with obstructive sleep apnea (OSA). Methods: Participants were 28 patients with OSA treated with CPAP who were enrolled immediately after diagnosis and graded according to the apnea hypopnea index (AHI) determined in an overnight polysomnography. Inclusion criteria were a new diagnosis of OSA and an indication for CPAP. Participants underwent a full ophthalmologic examination including standard automated perimetry (SAP) and optical coherence tomography (OCT) at the levels peripapillary, macular, and choroidal before CPAP onset, and after three and twelve months of CPAP. The data compared before and after treatment were intraocular pressure, SAP, and the thicknesses peripapillary retinal nerve fiber layer (pRNFL), total retinal (TR), retinal ganglion cell layer (RGCL), inner plexiform layer (IPL), photoreceptor layer (PL), and choroidal. Results: After 3 months of CPAP, we observed thickening of the pRNFL (in 5/6 subfields) (p < 0.004) and TR (in 5/9 subfields) (p < 0.010). At 12 months, thickening persisted in these layers, this time affecting 2/6 and 2/9 subfields, respectively (p < 0.012 and p < 0.001, respectively). Choroidal thinning was observed at the temporal level at both 3 and 12 months compared to measurements before starting CPAP treatment (p = 0.014 and p = 0.038, respectively). SAP remained unchanged. Intraocular pressure was higher at 12 months than at 3 months (p = 0.001). Conclusions: 12 months of CPAP avoids retinal thinning and normalizes choroidal thickness in OSA patients.

Effect of Continuous Positive Airway Pressure Given as Treatment for Obstructive Sleep Apnea on Central Corneal Thickness: Results at 12 Months

“…Treatment with CPAP has been shown to normalize the thickness of the retinal layers and choroid in OSA patients after 3 and 12 months of follow up [9]. Such effects were greater in the more vascularized retinal layers and choroid [10].…”

Reply to La Marca et al. Comment on “Naranjo-Bonilla et al. Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months. Int. J. Environ. Res. Public Health 2022, 19, 12637”

“…Thank you for your interest [1] in our work [2]. In all choroidal thickness (ChT) images, the drawn lines are at the level of the RPE.…”