Farahvash Armin, Micieli Jonathan A
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Eye Brain. 2020 Jul 7;12:61-71. doi: 10.2147/EB.S247121. eCollection 2020.
Obstructive sleep apnea (OSA) is a disease of obstructed airways during sleep that significantly impacts the quality of life and increases the risk of various systemic diseases. OSA has been studied as a risk factor for a number of neuro-ophthalmic conditions and a strong relationship has been established with non-arteritic anterior ischemic optic neuropathy (NAION). The incidence of glaucoma and stroke have also been significantly associated with OSA and are conditions that may also be seen by neuro-ophthalmologists. Patients with NAION have a significantly higher incidence of OSA and OSA diagnosis significantly increases the risk for NAION development. Non-compliance with continuous positive airway pressure (CPAP) in OSA patients has also been found to be a risk factor for fellow-eye involvement and there is increasing evidence to suggest that every patient with NAION should be formally evaluated with polysomnography. The relationship between OSA and idiopathic intracranial hypertension (IIH) has also been studied, but the relationship between these two conditions is less clear. There is insufficient evidence to recommend routine eye examinations in OSA patients for papilledema and conducting a sleep study for a newly diagnosed IIH patient should be left to the discretion of the clinician based on other symptoms and risk factors of OSA.
阻塞性睡眠呼吸暂停（OSA）是一种睡眠期间气道受阻的疾病，会显著影响生活质量，并增加患各种全身性疾病的风险。OSA已被作为多种神经眼科疾病的危险因素进行研究，并且已证实其与非动脉性前部缺血性视神经病变（NAION）存在密切关系。青光眼和中风的发病率也与OSA显著相关，而神经眼科医生也可能会诊治这些疾病。NAION患者的OSA发病率显著更高，而OSA诊断会显著增加NAION发生的风险。此外，OSA患者不依从持续气道正压通气（CPAP）治疗也被发现是对侧眼受累的危险因素，并且越来越多的证据表明，每位NAION患者都应接受多导睡眠图的正式评估。OSA与特发性颅内高压（IIH）之间的关系也已得到研究，但这两种疾病之间的关系尚不太明确。目前尚无足够证据推荐对OSA患者进行常规眼部检查以筛查视乳头水肿，对于新诊断的IIH患者是否进行睡眠研究，应根据OSA的其他症状和危险因素由临床医生自行决定。
