The Bruce Rappaport Faculty of Medicine, The Technion - Israel Institute of Technology, Haifa, Israel.
Clin Exp Ophthalmol. 2014 Mar;42(2):132-8. doi: 10.1111/ceo.12145. Epub 2013 Jul 15.
The study aims to investigate whether retinal nerve fibre layer (RNFL) abnormalities can be detected in patients with obstructive sleep apnoea/hypopnoea syndrome with normally appearing optic disc.
This is an observational case-control study.
One hundred and eight consecutive patients with moderate or severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS) as determined by overnight polysomnography and normal looking discs and 108 age-matched healthy controls were included in the study.
All patients underwent RNFL examinations by optical coherence tomography using fast retinal nerve fibre layer thickness scan.
The main outcome measure was RNFL thickness.
Multivariate regression analysis results showed that the RNFL was thinner for a patient with OSAHS than that of a normal control in the average by 4.20 μm (P < 0.003), in the superior quadrant by 4.83 μm (P = 0.028) and in the inferior quadrant by 5.19 μm (P = 0.016). RNFL thickness did not correlate with the severity of the disease.
RNFL thinning was detected in normal-looking discs of patients with advanced OSAHS, but the extent of this thinning did not correlate with the severity of the disease. Longitudinal follow-up is needed to clarify whether RNFL thinning in OSAHS patients with normal clinically appearing optic nerves will eventually lead to glaucoma.
本研究旨在探讨正常视盘外观的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者是否存在视网膜神经纤维层（RNFL）异常。
这是一项观察性病例对照研究。
本研究共纳入 108 例经夜间多导睡眠图（PSG）检查确诊为中重度 OSAHS 且视盘外观正常的患者和 108 例年龄匹配的健康对照者。
所有患者均接受光学相干断层扫描（OCT）的 RNFL 检查，采用快速视网膜神经纤维层厚度扫描。
主要观察指标为 RNFL 厚度。
多变量回归分析结果显示，与正常对照组相比，OSAHS 患者的 RNFL 平均厚度薄 4.20 μm（P<0.003），上方象限薄 4.83 μm（P=0.028），下方象限薄 5.19 μm（P=0.016）。RNFL 厚度与疾病严重程度无相关性。
在外观正常的 OSAHS 患者的视盘中发现了 RNFL 变薄，但这种变薄的程度与疾病的严重程度无关。需要进行纵向随访以明确 OSAHS 患者中正常临床视神经的 RNFL 变薄是否最终会导致青光眼。
