title: Retinal Nerve Fiber Layer Thickness Alteration in Apneic Children.
abstract: OBJECTIVE
  We examined retinal nerve fiber layer (RNFL) thickness alterations in children with chronic upper airway obstructions (UAOs) and obstructive sleep apnea syndrome (OSAS). We also investigated whether it was affected by an adenotonsillectomy operation.
  
  
  METHODS
  Forty-two children aged 3 to 8 years with chronic UAO resulting from adenotonsillar enlargement and 34 age-matched controls were included in the study. Patients underwent a Brouillette scoring questionnaire to be divided into mild (N = 10), moderate (N = 22), severe (N = 10), and total (N = 42) UAO groups. According to the scoring, the severe UAO group was defined as the severe OSAS group, the moderate group was suspicious for OSAS, and the mild UAO group was defined as the non-OSAS group. The patients' demographic data for age, sex, and body mass index were obtained. Ophthalmologic evaluations were performed with optical coherence tomography. Central corneal thickness, macular thickness, intraocular pressure (IOP), and RNFL thickness were measured. An adenotonsillectomy was performed on all patients, and eye examinations and scoring were repeated after the surgery.
  
  
  RESULTS
  Higher IOP levels were obtained between the total UAO group and the control group (p > 0.05). There were significant differences between UAO groups and the control group except for the moderate UAO group. There was no significant difference in RNFL thickness (p > 0.05) between preoperative UAO groups and the control group. However, after surgery, some significant differences emerged in the superior, inferior, and average RNFL thickness (p < 0.05). Also, IOP levels were significantly lower in the mild, moderate, and total UAO groups after the operation (p < 0.05).
  
  
  CONCLUSIONS
  Upper airway obstruction and OSAS seem to worsen some RNFL and IOP parameters in children, and eye examinations may be useful in these patients.
authors.affiliation: *MD †PhD Departments of Ophthalmology (AS, AHR, MC), Otolaryngology Head and Neck Surgery (CB, SD, YS, MK), and Biostatistics and Medical Informatics (FU), Adıyaman University Research and Education Hospital, Adıyaman, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Simsek
authors.forename: Cem
authors.initials: C
authors.lastname: Bayraktar
authors.forename: Sedat
authors.initials: S
authors.lastname: Dogan
authors.forename: Fatih
authors.initials: F
authors.lastname: Uckardes
authors.forename: Ali Hakim
authors.initials: AH
authors.lastname: Reyhan
authors.forename: Yasin
authors.initials: Y
authors.lastname: Sarikaya
authors.forename: Mehmet
authors.initials: M
authors.lastname: Karatas
authors.forename: Musa
authors.initials: M
authors.lastname: Capkin
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D063171:Corneal Pachymetry; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014068:Tonsillectomy