Zhao Xiao-Jing, Yang Cheng-Cheng, Zhang Jie-Chang, Zheng Hui, Liu Ping-Ping, Li Qin
*Department of Ophthalmology, The Fifth Affiliated Hospital, Sun Yat-sen University †Department of Cardiology, Zhuhai People's Hospital, Zhuhai, China.
J Glaucoma. 2016 Apr;25(4):e413-8. doi: 10.1097/IJG.0000000000000349.
The association between obstructive sleep apnea syndrome (OSAS) and retinal nerve fiber layer (RNFL) thickness has been examined in many studies. However, the findings are inconsistent. Our goal is to evaluate the association between OSAS and RNFL thickness by performing a meta-analysis.
We conducted a PubMed database search in November 2014 to identify studies on OSAS and RNFL. Reference lists of retrieved articles were also reviewed. A fixed-effects model was used to compute the summary mean difference (MD).
Six studies involving 1034 eyes were included in the meta-analysis. The overall combined MD of RNFL in OSAS patients compared with control participants was -2.03 µm [95% confidence interval (CI), -3.67 to -0.4; P=0.01]. The overall combined MDs of RNFL thickness in relation to moderate OSAS and severe OSAS were -2.49 µm (95% CI: -4.54 to -0.44; P=0.02) and -6.36 µm (95% CI: -8.4 to -4.32; P<0.001). But no significant difference was observed in mild OSAS; the combined MD was -2.05 µm (95% CI: -4.23 to 0.13; P=0.07). Association was also observed in OSAS and RNFL thickness of the inferior quadrant, with a combined MD of -3.31 µm (95% CI: -6.19 to -0.42; P=0.02).
This meta-analysis provides evidence that OSAS is associated with RNFL thickness. Furthermore, it was observed that the greater the severity of OSAS, the greater the loss of RNFL. Among the 4 quadrants observed, the most affected quadrant was the inferior quadrant, and the least affected was the temporal quadrant. OSAS may have an impact on changes in RNFL and therefore more attention should be paid to patients with this condition.
许多研究已对阻塞性睡眠呼吸暂停综合征（OSAS）与视网膜神经纤维层（RNFL）厚度之间的关联进行了检测。然而，研究结果并不一致。我们的目标是通过进行一项荟萃分析来评估OSAS与RNFL厚度之间的关联。
我们于2014年11月在PubMed数据库中进行了检索，以识别关于OSAS和RNFL的研究。还对检索到的文章的参考文献列表进行了审查。采用固定效应模型计算汇总平均差（MD）。
六项涉及1034只眼睛的研究被纳入荟萃分析。与对照组参与者相比，OSAS患者RNFL的总体合并MD为-2.03µm[95%置信区间（CI），-3.67至-0.4；P=0.01]。与中度OSAS和重度OSAS相关的RNFL厚度的总体合并MD分别为-2.49µm（95%CI：-4.54至-0.44；P=0.02）和-6.36µm（95%CI：-8.4至-4.32；P<0.001）。但在轻度OSAS中未观察到显著差异；合并MD为-2.05µm（95%CI：-4.23至0.13；P=0.07）。在OSAS与下象限的RNFL厚度之间也观察到关联，合并MD为-3.31µm（95%CI：-6.19至-0.42；P=0.02）。
这项荟萃分析提供了证据表明OSAS与RNFL厚度相关。此外，观察到OSAS的严重程度越高，RNFL的损失越大。在观察到的四个象限中，受影响最大的象限是下象限，受影响最小的是颞侧象限。OSAS可能会对RNFL的变化产生影响，因此应更加关注患有这种疾病的患者。
