Retinal Nerve Fiber Layer Thickness Alteration in Apneic Children

Şimşek, Ali; Bayraktar, Cem; Doğan, Sedat; Üçkardeş, Fatih; Reyhan, Ali Hakim; Sarıkaya, Yasin; Karataş, Mehmet; Capkin, Musa

doi:10.1097/opx.0000000000000745

Cited by 10 publications

(29 citation statements)

References 22 publications

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“…43 It has also been indicated that RGCs are more sensitive to ischemia than the more distal retinal cells. 44,45 Retinal hypoxia leads to increase in some mediators including vascular endothelial growth factor, nitric oxide, glutamate, inflammatory cytokines, and reactive oxygen species. Enhanced expression of these mediators causes RGCs loss by disruption of blood retinal barrier, excitotoxicity, and increased accumulation of intracellular Ca 2+ .…”

Section: Discussionmentioning

confidence: 99%

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

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Sayın

Bayramoğlu

et al. 2017

Eye

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PurposeTo investigate the association of the severity of obstructive sleep apnea syndrome (OSAS) with peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC-IPL).Materials and methodsIn this cross-sectional study, 145 patients with OSAS and 40 healthy subjects were enrolled. OSAS patients were further divided into mild (n=50), moderate (n=36), and severe (n=59) OSAS groups according to their apnea-hypopnea index (AHI) values. Spectral-domain optical coherence tomography was used to measure the peripapillary RNFL and GC-IPL thicknesses.ResultsThere was no statistical difference between the RNFL thickness in OSAS and control groups (P>0.05). Both average GC-IPL and minimum GC-IPL thicknesses were significantly lower in severe OSAS group than in healthy controls (P<0.05 for both). There was a significant negative correlation between AHI and both average GC-IPL (r=-0.232, P=0.005) and minimum GC-IPL (r=-0.233, P=0.005) thicknesses.ConclusionsOur study results suggest that although RNFL thickness did not differ significantly between OSAS and control groups, ganglion cell layer thickness in OSAS patients is much lower than in healthy population. Ganglion cell thickness showed a significant correlation with the severity of OSAS.

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Section: Discussionmentioning

confidence: 99%

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

Kara

Sayın

Bayramoğlu

et al. 2017

Eye

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“…Finally, we used a simple utility in a website to combine sample size, mean, and standard deviation from multiple groups into 1 group instead of excluding the study. In the premier of this analysis, we included 2 studies[ 22 23 ] that the research objects were children with chronic upper airway obstructions (UAOs)/obstructive sleep apnea syndrome (OSAS) and children with sleep-disordered breathing. From the heterogeneity test results, P values of total, mild, and moderate OSAS were 0.024, 0.511, and 0.257, respectively.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Objective:To investigate the changes of retinal nerve fiber layer (RNFL) thickness in obstructive sleep apnea syndrome (OSAS) patients.Methods:Relevant studies were selected from 3 major literature databases (PubMed, Cochrane Library, and EMBASE) without language restriction. Main inclusion criteria is that a case-control study in which RNFL thickness was measured by a commercial available optical coherence tomography (OCT) in OSAS patients. Meta-analysis was performed using STATA 12.0 software. Efficacy estimates were evaluated by weighted mean difference with corresponding 95% confidence intervals (CIs). Primary outcome evaluations were: the average changes of RNFL thickness in total OSAS patients, subgroup analysis of RNFL thickness changes in patients of different OSAS stages, and subgroup analysis of 4-quadrant RNFL thickness changes in total OSAS patients.Results:Of the initial 327 literatures, 8 case-control studies with 763 eyes of OSA patients and 474 eyes of healthy controls were included (NOS scores ≥6). For the people of total OSAS, there had an average 2.92 μm decreased RNFL thickness compared with controls (95% CI: −4.61 to −1.24, P = 0.001). For subgroup analysis of OSAS in different stages, the average changes of RNFL thickness in mild, moderate, severe, and moderate to severe OSAS were 2.05 (95% CI: −4.40 to 0.30, P = 0.088), 2.32 (95% CI: −5.04 to 0.40, P = 0.094), 4.21 (95% CI: −8.36 to −0.06, P = 0.047), and 4.02 (95% CI: −7.65 to −0.40, P = 0.03), respectively. For subgroup analysis of 4-quadrant, the average changes of RNFL thickness in Superior, Nasal, Inferior, and Temporal quadrant were 2.43 (95% CI: −4.28 to −0.57, P = 0.01), 1.41 (95% CI: −3.33 to 0.51, P = 0.151), 3.75 (95% CI: −6.92 to −0.59, P = 0.02), and 0.98 (95% CI: −2.49 to 0.53, P = 0.203), respectively.Conclusion:Our study suggests that RNFL thickness in OSAS patients is much thinner than healthy population, especially in superior and inferior quadrant. The impact of OSAS disease on RNFL and visual function should be taken seriously in the further study.

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“…Retina and optic nerve have been examined in OSAS paediatric patients with adenotonsillar hypertrophy with controversial results. Cinici and Tatar [10] found no signi cant alterations of RNFL thickness, while Simsek et al [11] showed that OSAS seems to in uence RNFL and IOP parameters. Both studies highlighted the potential risk of long-term optic injury due to blood intermittent hypoxia and recommend prompt treatment of OSAS in young people.…”

Section: Discussionmentioning

confidence: 96%

“…We examined children assessed for OSAS by overnight RP, to investigate for early signs of ocular changes related to airway obstruction during sleep, poorly documented and understood in the previous literature [10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have linked OSAS with glaucoma, keratoconus, papilloedema, nonarteritic ischemic optic neuropathy, age-related maculopathy and oppy eyelid syndrome (8-9); while very few and contradictory data can be found regarding paediatric ages. (10)(11) Aim of this study is to explore the early corneal, macular and optic nerve changes in paediatric patients with OSAS.…”

Section: Introductionmentioning

confidence: 99%

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Early Corneal and Optic Nerve Changes In Paediatric Population Affected By Obstructive Sleep Apnea Syndrome

Bonacci

Fasolo

Zaffanello

et al. 2021

Preprint

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PURPOSE: The relation between OSAS and eye diseases is well-known in adults, while very few and contradictory data can be found regarding paediatric ages. The aim of this study is to explore the early corneal, macular and optic nerve changes in paediatric patients with OSAS. METHODS: prospective study that enrolled children aged ≥ 4 years referred to the Paediatric Pneumology Clinic in Verona for suspected obstructive sleep apnea syndrome (OSAS) and investigated with the overnight respiratory polygraphy. Patients with apnea-hypopnea index (AHI)>1 were classified as OSAS, those with AHI<1 were classified non-OSAS. All patients underwent comprehensive eye examination including slit lamp, refraction, intraocular pression (Goldman applanation tonometry), corneal tomography (corneal astigmatism, corneal keratometry at the apex, Surface Asymmetry Index, Central corneal Thickness and Thinnest corneal Thickness), optical coherence tomography (central macular thickness, macular volume, and retinal nerve fiber layer).RESULTS: 72 children were enrolled in the study. The overall prevalence of OSAS was 48.6%. Statistically significant differences were found between OSAS and non-OSAS group for corneal asymmetry (0.9 ± 0.5 and 0.6 ±0.3, respectively; p=0.02), thinnest corneal thickness (551.8 ± 33.9 and 563.7 ±32.5; p= 0.04), average retinal nerve fiber layer (102.8 µm ± 10.5 and 98.1 µm ±12.3; p=0.012) and in nasal quadrant (76.2±15.4 µm and 66.5 ±12.6 µm; p= 0.0002).CONCLUSIONS: comprehensive eye examination with corneal and optic nerve imaging showed early corneal and optic nerve changes in children newly diagnosed with OSAS. These could be prelude of the known ocular manifestations associated with OSAS in adult patients.

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Retinal Nerve Fiber Layer Thickness Alteration in Apneic Children

Abstract: Upper airway obstruction and OSAS seem to worsen some RNFL and IOP parameters in children, and eye examinations may be useful in these patients.

Cited by 10 publications

References 22 publications

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

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

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

Early Corneal and Optic Nerve Changes In Paediatric Population Affected By Obstructive Sleep Apnea Syndrome

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