Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome.
BACKGROUND
To compare parameters for retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) measurements, and macular thickness in patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) versus normal controls.


METHODS
Patients presenting with snoring and daytime sleepiness who underwent overnight polysomnography to determine OSAHS severity were recruited, and subsequently referred for ophthalmologic evaluation. Optical coherence tomography was used to evaluate the retinal nerve fiber layer (RNFL), optic nerve head topography, and macular thickness for early detection of glaucoma. Patients determined not to have OSAHS were included as controls.


RESULTS
A total of 127 subjects were recruited, including 105 patients with OSAHS and 22 normal control subjects. RNFL thickness was significantly lower for the severe OSAHS group than for the control and mild OSAHS groups in the average (p < 0.0001) and in the superior quadrant (p = 0.0007). When subjects without OSAHS or with mild disease (AHI < 15) were grouped together and compared with patients with moderate/severe OSAHS (AHI ≧ 15), RNFL thickness measurements for the latter group were significantly lower in the average (p < 0.0001), and in the superior (p = 0.001), inferior (p = 0.029), and temporal (p = 0.007) quadrants. Positive correlations were identified between lowest oxygenation saturation on PSG and RNFL thickness in the average (r = 0.260), superior (r = 0.200) and nasal (r = 0.156) quadrants.


CONCLUSIONS
Compared to patients without OSAHS or those with mild disease, RNFL thickness was lower in patients with moderate/severe OSAHS. Lowest saturation of oxygen in the moderate/severe OSAHS group correlated with decreased RNFL thickness. Patients with moderate and severe OSAHS are at increased risk for glaucoma.
Lin
Pei-Wen
PW
Department of Ophthalmology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.
Friedman
Michael
M
Lin
Hsin-Ching
HC
Chang
Hsueh-Wen
HW
Pulver
Tanya M
TM
Chin
Chien-Hung
CH
D000328:Adult; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D017286:Polysomnography; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D041623:Tomography, Optical Coherence
D010100:Oxygen