title: Retinal sensitivity is reduced in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  To evaluate the outcomes of standard automated perimetry (SAP) in patients with obstructive sleep apnea (OSA).
  
  
  METHODS
  Eighty OSA patients and 111 age-matched controls were consecutively and prospectively enrolled. One eye per subject was randomly selected. All participants underwent at least one reliable SAP (24-2 SITA Standard algorithm). The peripapillary retinal nerve fiber layer thickness (RNFL) was measured with spectral-domain optical coherence tomography (OCT). Patients with OSA were classified into three groups according to the apnea/hypopnea index: mild, moderate, or severe OSA. Parameters of SAP and OCT were compared between healthy controls and OSA patients. Correlation of apnea/hypopnea index with OCT and SAP measurements were calculated.
  
  
  RESULTS
  Mean age, best-corrected visual acuity, and central corneal thickness were similar between groups. Intraocular pressure, however, was lower in the OSA group. Mean deviation of SAP was -0.23 ± 0.8 dB in the control group and -1.74 ± 2.8 dB in the OSA group (P < 0.001). Thickness of RNFL measured with OCT did not differ significantly between groups. Patients with OSA showed reduced sensitivity at most points tested by white-on-white perimetry compared with healthy individuals. The threshold values were more depressed in the peripheral visual field. The apnea/hypopnea index was related to the SAP indices: Pearson correlations were -0.432 with mean deviation, 0.467 with pattern standard deviation, and -0.416 with the visual field index (P < 0.001).
  
  
  CONCLUSIONS
  Patients with OSA exhibited reduced retinal sensitivity measured with SAP compared with healthy controls.
authors.affiliation: Department of Ophthalmology, Miguel Servet University Hospital, Aragon Health Sciences Institute, Zaragoza, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Ferrandez
authors.affiliation: Department of Ophthalmology, Miguel Servet University Hospital, Aragon Health Sciences Institute, Zaragoza, Spain University of Zaragoza, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ferreras
authors.affiliation: Department of Ophthalmology, Miguel Servet University Hospital, Aragon Health Sciences Institute, Zaragoza, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Calvo
authors.affiliation: Department of Ophthalmology, Miguel Servet University Hospital, Aragon Health Sciences Institute, Zaragoza, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Abadia
authors.affiliation: G.B. Bietti Foundation-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fogagnolo
authors.affiliation: Faculty of Medicine, University of Toronto, Canada.
authors.forename: Yaowu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pneumology, Miguel Servet University Hospital, Zaragoza, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Marin
authors.affiliation: University of Genoa, Genoa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Iester
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology / Q000503:physiopathology*; D011446:Prospective Studies; D012164:Retinal Diseases / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D012165:Retinal Ganglion Cells / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014794:Visual Fields / Q000502:physiology*
keywords: obstructive sleep apnea; optic disc; optical coherence tomography; retinal nerve fiber layer; visual field