Salzgeber R, Iliev M E, Mathis J
Ophthalmology, University of Bern, Inselspital, Bern, Switzerland (chairman: Prof. Dr. Dr. S. Wolf).
Neurology, University of Bern, Inselspital, Bern, Switzerland (chairman: Prof. Dr. C. L. Bassetti).
Klin Monbl Augenheilkd. 2014 Apr;231(4):340-3. doi: 10.1055/s-0034-1368260. Epub 2014 Apr 25.
It has been suggested that sleep apnea syndrome may play a role in normal-tension glaucoma contributing to optic nerve damage. The purpose of this study was to evaluate if optic nerve and visual field parameters in individuals with sleep apnea syndrome differ from those in controls.
From the records of the sleep laboratory at the University Hospital in Bern, Switzerland, we recruited consecutive patients with severe sleep apnea syndrome proven by polysomnography, apnea-hypopnea index >20, as well as no sleep apnea controls with apnea-hypopnea index <10. Participants had to be unknown to the ophtalmology department and had to have no recent eye examination in the medical history. All participants underwent a comprehensive eye examination, scanning laser polarimetry (GDx VCC, Carl Zeiss Meditec, Dublin, California), scanning laser ophthalmoscopy (Heidelberg Retina Tomograph II, HRT II), and automated perimetry (Octopus 101 Programm G2, Haag-Streit Diagnostics, Koeniz, Switzerland). Mean values of the parameters of the two groups were compared by t-test.
The sleep apnea group consisted of 69 eyes of 35 patients; age 52.7 ± 9.7 years, apnea-hypopnea index 46.1 ± 24.8. As controls served 38 eyes of 19 patients; age 45.8 ± 11.2 years, apnea-hypopnea index 4.8 ± 1.9. A difference was found in mean intraocular pressure, although in a fully overlapping range, sleep apnea group: 15.2 ± 3.1, range 8-22 mmHg, controls: 13.6 ± 2.3, range 9-18 mmHg; p<0.01. None of the extended visual field, optic nerve head (HRT) and retinal nerve fiber layer (GDx VCC) parameters showed a significant difference between the groups.
Visual field, optic nerve head, and retinal nerve fiber layer parameters in patients with sleep apnea did not differ from those in the control group. Our results do not support a pathogenic relationship between sleep apnea syndrome and glaucoma.
有人提出睡眠呼吸暂停综合征可能在正常眼压性青光眼中起作用，导致视神经损伤。本研究的目的是评估睡眠呼吸暂停综合征患者的视神经和视野参数是否与对照组不同。
从瑞士伯尔尼大学医院睡眠实验室的记录中，我们连续招募了经多导睡眠图证实患有严重睡眠呼吸暂停综合征（呼吸暂停低通气指数>20）的患者，以及呼吸暂停低通气指数<10的无睡眠呼吸暂停对照组。参与者必须不为眼科部门所知，且病史中近期无眼部检查。所有参与者均接受了全面的眼部检查、扫描激光偏振仪检查（GDx VCC，卡尔蔡司医疗技术公司，加利福尼亚州都柏林）、扫描激光眼底镜检查（海德堡视网膜断层扫描仪II，HRT II）和自动视野检查（Octopus 101程序G2，哈格-施特赖特诊断公司，瑞士科尼茨）。通过t检验比较两组参数的平均值。
睡眠呼吸暂停组由35例患者的69只眼组成；年龄52.7±9.7岁，呼吸暂停低通气指数46.1±24.8。作为对照组的是19例患者的38只眼；年龄45.8±11.2岁，呼吸暂停低通气指数4.8±1.9。虽然在完全重叠的范围内发现平均眼压存在差异，睡眠呼吸暂停组：15.2±3.1，范围8 - 22 mmHg，对照组：13.6±2.3，范围9 - 18 mmHg；p<0.01。两组之间的扩展视野、视神经乳头（HRT）和视网膜神经纤维层（GDx VCC）参数均未显示出显著差异。
睡眠呼吸暂停患者的视野、视神经乳头和视网膜神经纤维层参数与对照组无差异。我们的结果不支持睡眠呼吸暂停综合征与青光眼之间的致病关系。
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