Department of Ophthalmology, Toho University Sakura Medical Center, Chiba, Japan.
Cardiovascular Center Toho University Sakura Medical Center, Chiba, Japan.
Am J Ophthalmol. 2014 Jun;157(6):1202-8. doi: 10.1016/j.ajo.2014.01.028. Epub 2014 Feb 4.
To determine whether there is a significant correlation among the peripapillary retinal nerve fiber layer (RNFL) thickness, foveal thickness, total macular volume, and severity of obstructive sleep apnea syndrome.
Prospective study.
We studied 124 consecutive subjects who underwent polysomnography. Optical coherence tomography (OCT) was used to measure the peripapillary RNFL, foveal thickness, and total macular volume. The Pearson correlation coefficient was used to determine the relationship between the apnea-hypopnea index and OCT and other parameters. Multiple regression analysis was used to determine the independent factors for the RNFL sectors that were the most strongly correlated with the apnea-hypopnea index.
The apnea-hypopnea index was significantly and negatively correlated (right eye, r = -0.31, P = 0.0004; left eye, r = -0.39, P < 0.0001) with the nasal RNFL thickness (Pearson correlation analysis). The foveal thickness and total macular volume were not correlated. The intraocular pressure, body mass index, plaque score, and incidence of hypertension were negatively correlated, and the lowest oxygen saturation and mean oxygen saturation were positively correlated with the nasal RNFL thickness in the left eye. Multiple regression analysis showed that the apnea-hypopnea index and age were independent contributors to the nasal RNFL thickness in the left eye (apnea-hypopnea index, standard regression coefficient, -0.30, t value, -2.76, P = 0.007; age, -0.24, -2.36, 0.02, respectively). The nasal RNFL thickness in both eyes decreased significantly based on the severity of the obstructive sleep apnea syndrome.
Exacerbation of obstructive sleep apnea syndrome may produce unique retinal neurodegenerative disorders that decrease the nasal RNFL thickness.
确定阻塞性睡眠呼吸暂停综合征的严重程度与视盘周围视网膜神经纤维层（RNFL）厚度、黄斑中心凹厚度、总黄斑体积之间是否存在显著相关性。
前瞻性研究。
我们研究了 124 例连续接受多导睡眠图检查的患者。使用光学相干断层扫描（OCT）测量视盘周围 RNFL、黄斑中心凹厚度和总黄斑体积。采用 Pearson 相关系数来确定呼吸暂停低通气指数与 OCT 及其他参数之间的关系。采用多元回归分析来确定与呼吸暂停低通气指数相关性最强的 RNFL 区的独立影响因素。
呼吸暂停低通气指数与鼻侧 RNFL 厚度显著负相关（右眼，r=-0.31，P=0.0004；左眼，r=-0.39，P<0.0001）（Pearson 相关分析）。黄斑中心凹厚度和总黄斑体积无相关性。眼内压、体重指数、斑块评分和高血压发生率与鼻侧 RNFL 厚度呈负相关，而最低血氧饱和度和平均血氧饱和度与左眼鼻侧 RNFL 厚度呈正相关。多元回归分析显示，呼吸暂停低通气指数和年龄是左眼鼻侧 RNFL 厚度的独立影响因素（呼吸暂停低通气指数，标准回归系数-0.30，t 值-2.76，P=0.007；年龄，-0.24，-2.36，P=0.02）。根据阻塞性睡眠呼吸暂停综合征的严重程度，双眼鼻侧 RNFL 厚度均显著降低。
阻塞性睡眠呼吸暂停综合征的恶化可能导致独特的视网膜神经退行性疾病，使鼻侧 RNFL 厚度变薄。
