Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Clin Sleep Med. 2022 Jan 1;18(1):47-56. doi: 10.5664/jcsm.9488.
This study aimed to identify prospectively the correlation between obstructive sleep apnea (OSA) severity, ocular microcirculation changes, and visual function changes in patients with glaucoma.
We prospectively enrolled patients with glaucoma who were willing to undergo overnight polysomnography. The enrolled patients were further divided into normal tension glaucoma, high-tension glaucoma, and control. Visual field progression was analyzed using sequential standard automated perimetry. Peripapillary and macular vessel density were assessed through optical coherence tomography angiography (OCT-angiography). The associations between polysomnography parameters, OCT-angiography parameters, and visual field progression were analyzed.
A total of 22 patients with normal tension glaucoma, 30 patients with high-tension glaucoma, and 24 control patients were enrolled. Through regression analysis, glaucoma was found to be an independent predictor of moderate-to-severe OSA ( = .035); furthermore, moderate-to-severe OSA was significantly associated with visual field progression ( = .008 in the high-tension glaucoma subgroup and = .008 in the overall glaucoma). Additionally, OSA severity was negatively correlated with the ganglion cell complex thinning rate in the normal tension glaucoma subgroup.
Presence of glaucoma increased the risk of moderate-to-severe OSA compared with the control group. OSA severity was related to visual field deterioration in patients with glaucoma and further associated with structural progression in the normal tension glaucoma subgroup. Careful monitoring of the comorbid OSA status of patients with glaucoma is essential to prevent disease progression.
Chan Y-H, Chuang L-H, Yu C-C, et al. Prospective evaluation of the comorbidity of obstructive sleep apnea in patients with glaucoma. . 2022;18(1):47-56.
本研究旨在前瞻性地确定阻塞性睡眠呼吸暂停（OSA）严重程度、青光眼患者眼微循环变化和视觉功能变化之间的相关性。
我们前瞻性地招募了愿意接受夜间多导睡眠图检查的青光眼患者。将入组患者进一步分为正常眼压性青光眼、高眼压性青光眼和对照组。使用序贯标准自动视野计分析视野进展情况。通过光学相干断层扫描血管造影（OCT-angiography）评估视盘周围和黄斑血管密度。分析多导睡眠图参数、OCT-angiography 参数与视野进展之间的相关性。
共纳入 22 例正常眼压性青光眼患者、30 例高眼压性青光眼患者和 24 例对照组患者。通过回归分析，青光眼是中重度 OSA 的独立预测因素（ =.035）；此外，中重度 OSA 与视野进展显著相关（高眼压亚组中 =.008，总体青光眼组中 =.008）。此外，OSA 严重程度与正常眼压性青光眼亚组的神经节细胞复合体变薄率呈负相关。
与对照组相比，青光眼的存在增加了发生中重度 OSA 的风险。OSA 严重程度与青光眼患者的视野恶化有关，并与正常眼压性青光眼亚组的结构进展进一步相关。对青光眼患者合并 OSA 状态进行仔细监测，对于预防疾病进展至关重要。
Chan Y-H, Chuang L-H, Yu C-C, et al. 前瞻性评估青光眼患者合并阻塞性睡眠呼吸暂停的共病情况。. 2022;18(1):47-56.
