Mojon D S, Hess C W, Goldblum D, Fleischhauer J, Koerner F, Bassetti C, Mathis J
Department of Ophthalmology, University of Bern, Switzerland.
Ophthalmology. 1999 May;106(5):1009-12. doi: 10.1016/S0161-6420(99)00525-4.
To determine the prevalence of glaucoma in sleep apnea syndrome (SAS), an entity characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of cardiovascular and neurologic sequelae.
Cross-sectional study.
A total of 114 white patients consecutively referred for polysomnographic evaluation of suspected SAS.
Complete ophthalmologic examination, including computerized perimetry and simultaneous stereoscopic optic disc photographs.
Spearman rank correlations between the respiratory disturbance index during night sleep (RDI), a value used to diagnose and grade SAS, and visual acuity, intraocular pressure (IOP), visual field indices, presence or absence of glaucomatous optic disc changes, and diagnosis of glaucoma. Each correlation was controlled for age and body mass index. To compare proportions of patients harboring glaucoma, the binomial test was used.
Sixty-nine (60.5%) of the 114 patients had an RDI > or =10, which indicates SAS. Three patients had primary open-angle glaucoma, and two had normal-tension glaucoma. All patients with glaucoma had SAS. The observed prevalence of glaucoma in patients with SAS (5 of 69, 7.2%) was significantly higher than expected in a white population (2%) (P = 0.01). The RDI correlated positively with IOP (P = 0.025), visual field loss variance (P = 0.03), glaucomatous optic disc changes (P = 0.001), and diagnosis of glaucoma (P = 0.01).
Patients with SAS constitute a high-risk population for glaucoma and should therefore be screened for glaucoma.
确定睡眠呼吸暂停综合征（SAS）患者中青光眼的患病率。SAS的特征是睡眠期间反复出现上呼吸道阻塞，导致缺氧和睡眠中断，伴有心血管和神经后遗症风险。
横断面研究。
共有114名白人患者因疑似SAS接受多导睡眠图评估而连续就诊。
进行全面眼科检查，包括电脑视野检查和同步立体视盘照片。
夜间睡眠呼吸紊乱指数（RDI，用于诊断和分级SAS的指标）与视力、眼压（IOP）、视野指标、是否存在青光眼性视盘改变以及青光眼诊断之间的Spearman等级相关性。每项相关性均根据年龄和体重指数进行校正。为比较青光眼患者比例，采用二项式检验。
114名患者中有69名（60.5%）RDI≥10，提示存在SAS。3例患者患有原发性开角型青光眼，2例患有正常眼压性青光眼。所有青光眼患者均患有SAS。SAS患者中青光眼的观察患病率（69例中有5例，7.2%）显著高于白人人群的预期患病率（2%）（P = 0.01）。RDI与IOP（P = 0.025）、视野缺损方差（P = 0.03）、青光眼性视盘改变（P = 0.001）以及青光眼诊断（P = 0.01）呈正相关。
SAS患者是青光眼的高危人群，因此应进行青光眼筛查。
