Université Grenoble Alpes, Grenoble, France2Department of Ophthalmology, University Hospital, Grenoble, France3INSERM U1042, Lab Hypoxia and Physiopathology, Université Grenoble Alpes, Grenoble, France.
Université Grenoble Alpes, Grenoble, France2Department of Ophthalmology, University Hospital, Grenoble, France.
JAMA Ophthalmol. 2015 Jul;133(7):797-804. doi: 10.1001/jamaophthalmol.2015.0893.
The prevalence of obstructive sleep apnea syndrome (OSAS) in patients with nonarteritic anterior ischemic optic neuropathy (NAION) and its influence on second eye involvement is not well known.
To evaluate the prevalence of OSAS in patients with NAION and risk factors of second eye involvement.
DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, we examined 118 patients with anterior ischemic optic neuropathy referred to a tertiary care center from January 1, 2003, through December 31, 2010.
Patients underwent polysomnography to detect OSAS and were prospectively followed up to assess the risk of second eye involvement.
The prevalence of OSAS in patients with NAION and the risk of second eye involvement using survival analysis based on the presence of OSAS, indication for ventilation treatment with continuous positive airway pressure, and other potential ocular and systemic confounders.
In 89 patients with NAION who underwent polysomnography, 67 (75%) had OSAS. Second eye involvement was found in 10 (13.7%) of 73 patients at 3 years: 8 (15.4%) of 52 patients with OSAS at 3 years and 2 (9.5%) of 21 patients without OSAS at 3 years; P = .04. In multivariate analysis, nonadherence to ventilation treatment with continuous positive airway pressure in patients with severe OSAS increased the risk of second eye involvement (hazard ratio, 5.54; 95% CI, 1.13-27.11; P = .04).
These results suggest that OSAS is common in patients with NAION and that polysomnography should be considered in these patients. These findings also suggest that patients with severe OSAS who are nonadherent to ventilation treatment with continuous positive airway pressure have an increased risk of second eye involvement.
非动脉炎性前部缺血性视神经病变（NAION）患者阻塞性睡眠呼吸暂停综合征（OSAS）的患病率及其对第二眼受累的影响尚不清楚。
评估 NAION 患者中 OSAS 的患病率和第二眼受累的危险因素。
设计、地点和参与者：在这项队列研究中，我们检查了 2003 年 1 月 1 日至 2010 年 12 月 31 日期间到一家三级保健中心就诊的 118 例前部缺血性视神经病变患者。
患者接受多导睡眠图检查以检测 OSAS，并进行前瞻性随访以评估第二眼受累的风险。
根据存在 OSAS、持续气道正压通气通气治疗的适应证以及其他潜在的眼部和全身混杂因素，评估 NAION 患者中 OSAS 的患病率和第二眼受累的风险，采用生存分析。
在 89 例行多导睡眠图检查的 NAION 患者中，67 例（75%）患有 OSAS。3 年内，73 例患者中有 10 例（13.7%）发生第二眼受累：3 年内，52 例 OSAS 患者中有 8 例（15.4%），21 例无 OSAS 患者中有 2 例（9.5%）；P=0.04。多变量分析显示，严重 OSAS 患者对持续气道正压通气通气治疗的不依从性增加了第二眼受累的风险（危险比，5.54；95%CI，1.13-27.11；P=0.04）。
这些结果表明，OSAS 在 NAION 患者中很常见，应考虑对这些患者进行多导睡眠图检查。这些发现还表明，不依从持续气道正压通气通气治疗的严重 OSAS 患者第二眼受累的风险增加。
