Retinal and choroidal thickness evaluation by SD-OCT in adults with obstructive sleep apnea-hypopnea syndrome (OSAS)

Abstract

Objective To assess the macular retina and choroidal thickness change in patients with obstructive sleep apnea-hypopnea syndrome (OSAS) with no significant symptoms and pathological changes in the fundus using spectral domain-optical coherence tomography. Methods This prospective, observational case-control study consisted of 53 eyes of 53 patients with OSAS and 12 eyes of 12 age-matched controls. Macular and choroidal thicknesses were measured by optical coherence tomography. Results The foveal and nasal macular thicknesses were significantly different between four groups (P ¼ 0.001, P ¼ 0.016). The foveal thickness of the control group was significantly thinner than that of the severe group (P ¼ 0.000). The nasal macular thickness of the control group was significantly thinner than that of the severe group (P ¼ 0.008). A significant correlation was found between oxygen desaturation index (ODI) and macular center thickness (r ¼ 0.357, R 2 ¼ 0.127, P ¼ 0.004), with an ODI coefficient of 0.457 (P ¼ 0.004). Similarly, a significant correlation was found between ODI and nasal macular thickness (r ¼ 0.265, R 2 ¼ 0.070, P ¼ 0.033), with an ODI coefficient of 0.233 (P ¼ 0.033). The subfoveal choroidal thickness was significantly different among the groups (F ¼ 3.657, P ¼ 0.017). The subfoveal choroidal thickness of the severe group was significantly thinner than that of the control group, mild group, and moderate group (P ¼ 0.023, 0.006, and 0.036, respectively). The choroidal thickness 1 mm nasal to the fovea was significantly different between the groups after correcting for age and diopter (F ¼ 3.411, P ¼ 0.023). The choroidal thickness 1 mm nasal to the fovea was significantly thinner in the severe group compared with the control group and mild group (P ¼ 0.013 and 0.010, respectively). Choroidal thickness was significantly correlated with diopter (r ¼ 0.520, R 2 ¼ 0.270, Po0.001), with a coefficient of 0.327 (Po0.001), and with ODI (r ¼ 0.520, R 2 ¼ 0.165, P ¼ 0.001), with a coefficient of À 0.370 (P ¼ 0.001). Conclusions OSAS patients showed decreased foveal and nasal macular thickness, similar to the subfoveal and nasal choroidal thickness. These findings suggest that, because of intermittent hypoxia, OSAS might change the retinal and choroidal blood supply.

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

“…This might be due to the origin of the control group that has some suspicious symptoms related with possible sleep disorders, and the small number of subjects. Also, this study revealed a negative correlation between AHI severity and SFCT (28) . However, OSAHS is a risk factor for central serous chorioretinopathy etiology, which has been reported to accompany subfoveal choroidal effusion (7) .…”

Evaluation of choroidal thickness measurements in pediatric obstructive sleep apnea syndrome patients

“…Tonini et al 13 found similar choroidal blood flow reactivity to CO 2 and O 2 in the OSAS patients and controls in their prospective study, and concluded that ocular microcirculation, which provides adaptive mechanisms, continues long-term in OSAS patients. Contrarily, Xin et al 12 observed significantly lower measurements in severe OSAS patients with regard to the subfoveal and nasal choroidal thicknesses, when compared with the mild-moderate OSAS patients and control subjects. Additionally, Bayhan et al 11 reported significantly thinner choroidal thicknesses 1.5 mm and 3.0 mm nasal to the fovea in severe OSAS patients, when compared with the controls.…”

“…The normal function and structure of the choroid is essential for proper retinal function 11,12,14 . The choroid mainly supplies the outer layers of the retina, which contain photoreceptors, and abnormal flow changes may cause photoreceptor death or dysfunction 21 .…”

“…The choroid is one of the most highly vascularized tissues in humans, and due to OSAS, hypoxia, hypercapnia, impaired balance in the endothelial vasoactive substances, hemodynamic changes, and autonomic dysfunction may all cause impairment in the choroidal blood flow 11 . In previous studies, alterations in the choroidal thickness have been shown in adults with OSAS [11][12][13][14] . To the best of our knowledge, this is the first study to investigate the choroidal blood flow in the pediatric OSAS population.…”

Choroidal thickness alterations in obstructive sleep apnea–hypopnea syndrome (OSAS)

“…1 We present a case where permanent vision loss was prevented by prompt recognition of the condition seen on fluorescein angiography (FA). To our knowledge, this is the first report of fluorescein angiographic evidence of reversible retinal circulatory abnormalities associated with GCA.…”