Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Sleep Center, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Eye (Lond). 2019 Sep;33(9):1459-1465. doi: 10.1038/s41433-019-0430-2. Epub 2019 Apr 10.
BACKGROUND/OBJECTIVES: To investigate the correlation between obstructive sleep apnea (OSA) severity and the structural and functional progression in patients with glaucoma.
SUBJECTS/METHODS: This retrospective comparative cohort study included subjects from the polysomnography database in Chang Gung Memorial Hospital between June 1, 2009, and June 1, 2017, by identifying patients who had received diagnoses of primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), or glaucoma suspect. Patients with follow-up time of <3 years and/or <3 consecutive reliable optical coherence tomography (OCT) or visual field (VF) tests were excluded. Progression of overall peripapillary retinal nerve fiber layer (RNFL) thickness on OCT scans and VF mean deviation (MD) or VF index (VFI) were determined through linear regression trend analysis.
Thirty-two patients were included. There was a trend to higher percentage of progression on RNFL thickness and VF in higher OSAS severity. After stratifying patients to no OSA/mild OSA (group 1) and moderate/severe OSA (group 2), group 2 exhibited a significantly higher percentage of RNFL thickness progression than did group 1 (64.7% vs 26.7%, P = 0.042). Multivariate Cox regression analysis showed that severe OSA had an 8.448-fold higher risk of RNFL thickness progression after age, sex, diabetes mellitus, hypertension, hyperlipidemia, and body mass index adjustment (95% confidence interval, 1.464-48.752, P = 0.017).
Severe OSA is significantly correlated with a higher risk of structural deterioration in patients with glaucoma.
背景/目的：探讨阻塞性睡眠呼吸暂停（OSA）严重程度与青光眼患者结构和功能进展的相关性。
受试者/方法：本回顾性对比队列研究纳入了 2009 年 6 月 1 日至 2017 年 6 月 1 日期间长庚纪念医院多导睡眠图数据库中的受试者，通过确定患有原发性开角型青光眼（POAG）、正常眼压性青光眼（NTG）或青光眼疑似患者的患者。排除随访时间<3 年和/或<3 次连续可靠的光学相干断层扫描（OCT）或视野（VF）检查的患者。通过线性回归趋势分析确定 OCT 扫描和 VF 平均偏差（MD）或 VF 指数（VFI）上整体视盘周围视网膜神经纤维层（RNFL）厚度的进展情况。
共纳入 32 名患者。RNFL 厚度和 VF 的进展百分比呈上升趋势，OSAS 严重程度越高。将患者分层为无 OSA/轻度 OSA（组 1）和中重度 OSA（组 2）后，组 2 的 RNFL 厚度进展百分比明显高于组 1（64.7%比 26.7%，P=0.042）。多变量 Cox 回归分析显示，校正年龄、性别、糖尿病、高血压、高血脂和体重指数后，严重 OSA 使 RNFL 厚度进展的风险增加 8.448 倍（95%置信区间，1.464-48.752，P=0.017）。
严重 OSA 与青光眼患者结构恶化的风险显著相关。
