Mojon Daniel S, Hedges Thomas R, Ehrenberg Bruce, Karam Emely Z, Goldblum David, Abou-Chebl Alex, Gugger Matthias, Mathis Johannes
New England Eye Center, 750 Washington St, Box 381, Boston, MA 02111, USA.
Arch Ophthalmol. 2002 May;120(5):601-5. doi: 10.1001/archopht.120.5.601.
To determine if patients with nonarteritic ischemic optic neuropathy (NAION) have sleep apnea syndrome (SAS), an entity characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption.
We recruited 17 patients with NAION and 17 age- and sex-matched controls from patients referred for treatment because of suspected restless legs syndrome. We performed overnight polysomnography and determined the respiratory disturbance index during night sleep, a value used to diagnose and grade SAS. We compared the proportions of patients with SAS among patients with NAION and matched controls using the chi(2) test. Additionally, we compared the proportions of patients with SAS among patients with NAION and a large SAS prevalence study using the binomial test.
Twelve (71%) of 17 patients with NAION had SAS. According to the respiratory disturbance index, 4 patients (24%) had mild, 4 patients (24%) had moderate, and 4 patients (24%) had severe SAS. Only 3 (18%) of 17 controls had SAS (P =.005). In the 45- to 64-year age group, 4 (50%) of 8 patients with NAION had SAS; 51 (11.9%) of 430 of the random sample in the prevalence study had SAS (P =.005). In the group older than 64 years, 8 (89%) of 9 patients with NAION had SAS; 18 (24%) of 75 of the random sample in the prevalence study had SAS (P<.001).
We found a high prevalence of SAS in patients with NAION, which supports previous case reports suggesting that such an association exists. This association may explain why approximately 75% of all patients with NAION discover visual loss on first awakening or when they first use vision critically after sleeping. Our findings indicate that SAS may play an important role in the pathogenesis of NAION.
确定非动脉炎性缺血性视神经病变（NAION）患者是否患有睡眠呼吸暂停综合征（SAS），这是一种以睡眠期间反复上呼吸道阻塞为特征的病症，可导致缺氧和睡眠中断。
我们从因疑似不安腿综合征而转诊接受治疗的患者中招募了17例NAION患者以及17例年龄和性别匹配的对照。我们进行了整夜多导睡眠图检查，并确定了夜间睡眠期间的呼吸紊乱指数，该值用于诊断和分级SAS。我们使用卡方检验比较了NAION患者和匹配对照中SAS患者的比例。此外，我们使用二项式检验比较了NAION患者与一项大型SAS患病率研究中SAS患者的比例。
17例NAION患者中有12例（71%）患有SAS。根据呼吸紊乱指数，4例患者（24%）患有轻度SAS，4例患者（24%）患有中度SAS，4例患者（24%）患有重度SAS。17例对照中只有3例（18%）患有SAS（P = 0.005）。在45至64岁年龄组中，8例NAION患者中有4例（50%）患有SAS；患病率研究随机样本中的430例中有51例（11.9%）患有SAS（P = 0.005）。在64岁以上年龄组中，9例NAION患者中有8例（89%）患有SAS；患病率研究随机样本中的75例中有18例（24%）患有SAS（P<0.001）。
我们发现NAION患者中SAS的患病率很高，这支持了先前表明存在这种关联的病例报告。这种关联可能解释了为什么所有NAION患者中约75%在首次醒来时或睡眠后首次严重使用视力时发现视力丧失。我们的研究结果表明，SAS可能在NAION的发病机制中起重要作用。
