Nadarajah Suchitra, Samsudin Amir, Ramli Norlina, Tan Chong Tin, Mimiwati Zahari
1Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 2Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia *
Optom Vis Sci. 2017 Oct;94(10):981-985. doi: 10.1097/OPX.0000000000001117.
To our knowledge, this is the first time a study looking at the association between corneal hysteresis (CH) and obstructive sleep apnea syndrome (OSAS) severity has been reported. We provide evidence that CH is lower in OSAS and speculate on the possible causes.
The present study aims to look at the association between CH and severity of OSAS, and whether CH could be another link between OSAS and the development of glaucoma.
This was a cross-sectional, observational study at the University Malaya Medical Centre, Kuala Lumpur. Patients undergoing polysomnography for assessment of OSAS were recruited. We measured central corneal thickness (CCT) using optical biometry, and CH using ocular response analysis. Intraocular pressure (IOP) and Humphrey visual field (HVF) indices were also measured. The Apnea Hypopnea Index (AHI) divided patients into normal, mild, moderate, and severe OSAS categories. The normal and mild categories (47.9%) were then collectively called group 1, and the moderate and severe categories (52.1%) were called group 2. T tests, Pearson correlation tests, and general linear model analysis were performed, with P <.05 considered statistically significant.
One eye each from 117 patients (75 men, 42 women) was included. Patients in group 2 had lower CH (9.8 ± 1.4 vs. 10.3 ± 1.1 mm Hg, P = .029), with unchanged estimated marginal means after correcting for age, sex, CCT, and IOP (P = .026). There were no statistically significant differences in IOP, CCT, or HVF indices between the two groups (all P > .05). CH correlated negatively with AHI (r = -0.229, P = .013) and positively with lowest oxygen saturation (r = 0.213, P = .022).
CH is lower in moderate/severe OSAS than in normal/mild cases. This may be another link between OSAS and the development of glaucoma; further studies are indicated to determine the significance of this connection.
据我们所知，这是首次有研究报道角膜滞后（CH）与阻塞性睡眠呼吸暂停综合征（OSAS）严重程度之间的关联。我们提供了证据表明OSAS患者的CH较低，并推测了可能的原因。
本研究旨在探讨CH与OSAS严重程度之间的关联，以及CH是否可能是OSAS与青光眼发生之间的另一个联系。
这是一项在吉隆坡马来亚大学医学中心进行的横断面观察性研究。招募接受多导睡眠图检查以评估OSAS的患者。我们使用光学生物测量法测量中央角膜厚度（CCT），并使用眼反应分析仪测量CH。还测量了眼压（IOP）和汉弗莱视野（HVF）指标。呼吸暂停低通气指数（AHI）将患者分为正常、轻度、中度和重度OSAS类别。然后将正常和轻度类别（47.9%）统称为第1组，中度和重度类别（52.1%）称为第2组。进行了t检验、Pearson相关检验和一般线性模型分析，P <.05被认为具有统计学意义。
纳入了117例患者（75例男性，42例女性）的单眼数据。第2组患者的CH较低（9.8±1.4 vs. 10.3±1.1 mmHg，P =.029），在校正年龄、性别、CCT和IOP后估计边际均值无变化（P =.026）。两组之间的IOP、CCT或HVF指标无统计学显著差异（所有P >.05）。CH与AHI呈负相关（r = -0.229，P =.013），与最低血氧饱和度呈正相关（r = 0.213，P =.022）。
中度/重度OSAS患者的CH低于正常/轻度患者。这可能是OSAS与青光眼发生之间的另一个联系；需要进一步研究以确定这种联系的意义。
