Tong Jessica Y, Golzan Mojtaba, Georgevsky Dana, Williamson Jonathan P, Graham Stuart L, Farah Claude S, Fraser Clare L
Faculty of Medicine and Health Sciences, Macquarie University Ophthalmology, Macquarie University, Australia.
Faculty of Medicine and Health Sciences, Macquarie University Ophthalmology, Macquarie University, Australia.
Am J Ophthalmol. 2017 Oct;182:72-80. doi: 10.1016/j.ajo.2017.07.012. Epub 2017 Jul 20.
To examine the relationship between both static and dynamic retinal vascular caliber and the severity of obstructive sleep apnea (OSA).
Prospective cross-sectional study.
Adult patients undergoing diagnostic polysomnography studies at a private Australian university teaching hospital were recruited. OSA severity was defined by the apnea-hypopnea index (AHI): severe >30, moderate >15-30, mild 5-15, and controls <5. Of 115 patients recruited (73 male; mean age 58 ± 13 years), there were 41 severe, 35 moderate, and 25 mild OSA patients and 14 controls. Static retinal vascular caliber was measured as the average diameter of retinal arterioles (CRAE) and venules (CRVE), and summarized as the arteriovenous ratio (AVR). Dynamic retinal vascular caliber was evaluated as the average pulsation amplitude of retinal arterioles (SRAP) and venules (SRVP). Comparisons across groups were performed using multivariate linear regression analysis. All results were adjusted for age, body mass index, and mean arterial pressure.
Increasing AHI was significantly associated with decreasing AVR (P = .008) and CRAE (P = .016). A significant relationship was demonstrated between increasing AHI and attenuated retinal vascular pulsation amplitude (arterioles P = .028; venules P < .0001).
Increasing OSA severity is independently associated with retinal arteriolar narrowing and attenuated vascular pulsation amplitude. The retinal vasculature is easily imaged, and may be a surrogate biomarker of cerebral and systemic vascular risk in patients with OSA requiring further comprehensive investigation.
研究静态和动态视网膜血管管径与阻塞性睡眠呼吸暂停（OSA）严重程度之间的关系。
前瞻性横断面研究。
招募在澳大利亚一所私立大学教学医院接受诊断性多导睡眠图研究的成年患者。OSA严重程度由呼吸暂停低通气指数（AHI）定义：重度>30，中度>15 - 30，轻度5 - 15，对照组<5。在招募的115例患者（73例男性；平均年龄58±13岁）中，有41例重度、35例中度和25例轻度OSA患者以及14例对照组。静态视网膜血管管径测量为视网膜小动脉（CRAE）和小静脉（CRVE）的平均直径，并总结为动静脉比（AVR）。动态视网膜血管管径评估为视网膜小动脉（SRAP）和小静脉（SRVP）的平均搏动幅度。使用多变量线性回归分析进行组间比较。所有结果均根据年龄、体重指数和平均动脉压进行调整。
AHI增加与AVR降低（P = .008）和CRAE降低（P = .016）显著相关。AHI增加与视网膜血管搏动幅度减弱之间存在显著关系（小动脉P = .028；小静脉P < .0001）。
OSA严重程度增加与视网膜小动脉狭窄和血管搏动幅度减弱独立相关。视网膜血管系统易于成像，可能是需要进一步全面研究的OSA患者脑和全身血管风险的替代生物标志物。
