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

Abstract

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.

Glaucoma Is Associated with the Risk of Obstructive Sleep Apnea: A Population-Based Nationwide Cohort Study

“…Additionally, one study showed the thinning of the RNFL superotemporally by 1.5 µm with an increase in the apnea-hypopnea index by 5 events per hour [ 19 ]. Several studies have described the occurrence of OSA in patients with glaucoma [ 12 , 20 , 21 , 22 ]. One study demonstrated that patients with severe OSA had >8 times RNFL thickness progression than patients with none or mild OSA [ 20 ].…”

Assessment of the Effectiveness of Obstructive Sleep Apnea Treatment Using Optical Coherence Tomography to Evaluate Retinal Findings

“…Regarding the optic nerve parameters in OCT, Lin et al [19], Casas et al [20], and Uslu et al [31] reported a greater excavation optic nerve head area (cup area) in OSAS patients than in controls. Kücük et al [36] showed that the lamina cribosa thickness was significantly thinner in OSAS patients than in controls.…”

“…In addition, it provides fast and non-invasive information on macula layer thickness, the peripapillary retinal nerve fiber layer (RNFL) and the optic nerve head (ONH) [17]. Some studies have already demonstrated retinal changes in OSAS patients, such as increased thickness in mildmoderate OSAS patients, a so-called inflammation, or a decrease in retinal thickness-a degenerative neurological process-in severe OSAS patients [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Assessment of the Effectiveness of Obstructive Sleep Apnea Treatment Using Optical Coherence Tomography to Evaluate Retinal Findings

“…Regarding optic nerve parameters in OCT, Lin et al [14], Casas et al [15], and Uslu et al [26] have reported a greater excavation optic nerve head area (cup area) in OSAS patients than in controls. Kücük et al [36] have shown that the lamina cribosa thickness was significantly thinner in OSAS patients than in controls.…”

“…In addition, it provides fast and non-invasive information of macula layer thickness, peripapillary retinal nerve fiber layer (RNFL) and the optic nerve head (ONH) [12]. Some studies have already demonstrated retinal changes in OSAS patients, such as increased thickness in mild-moderate OSAS patients, a so-called inflammation, or a decrease in retinal thickness in severe OSAS patients, a degenerative neurological process [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”