Ophthalmology Department, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
Ophthalmology Department, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain.
Graefes Arch Clin Exp Ophthalmol. 2021 Nov;259(11):3381-3393. doi: 10.1007/s00417-021-05322-w. Epub 2021 Jul 23.
To examine retinal and choroidal thicknesses in individuals with obstructive sleep apnea (OSA) and determine the impacts of continuous positive airway pressure (CPAP) treatment.
Prospective follow-up study conducted at a university hospital. 40 patients with OSA, 28 treated with CPAP, and 12 untreated, were enrolled immediately after diagnosis and graded according to the apnea hypopnea index (AHI) determined in an overnight polysomnography. Inclusion criteria were a new diagnosis of OSA and CPAP indicated. Participants underwent a full ophthalmologic examination including optical coherence tomography (OCT) at the peripapillary, macular, and choroidal levels and the same examination 3 months later. Outcome measures were peripapillary retinal nerve fiber layer (RNFL), total retinal (TRT), retinal ganglion cell layer (RGCL), inner plexiform layer (IPL), photoreceptor layer (PL), and choroidal thicknesses.
At 3 months, RGCL thickness was reduced at the inner nasal macula segment in the no-CPAP group (P = 0.016). In + CPAP, increases were produced in RNFL thickness (5/6 segments) and TRT (7/ 9 segments), while choroidal thinning was observed temporally (P = 0.003). At baseline, positive correlation was detected between choroidal thickness and AHI (r = 0.352, P = 0.005) and between IPL thickness (7/9 segments) and AHI (r = 0.414, P < 0.001).
Initial retinal and choroidal thickening was followed by RGCL thinning over 3 months. In patients receiving CPAP, we observed no thinning of any retinal layer and normalization of choroidal thickness.
观察阻塞性睡眠呼吸暂停（OSA）患者的视网膜和脉络膜厚度，并确定持续气道正压通气（CPAP）治疗的影响。
在一所大学医院进行前瞻性随访研究。在诊断后立即招募了 40 名 OSA 患者，其中 28 名接受 CPAP 治疗，12 名未接受治疗，并根据整夜多导睡眠图确定的呼吸暂停低通气指数（AHI）进行分级。纳入标准为新诊断的 OSA 和 CPAP 指征。所有患者均接受全面眼科检查，包括视盘周围、黄斑和脉络膜水平的光学相干断层扫描（OCT），并在 3 个月后进行相同检查。观察指标为视盘周围视网膜神经纤维层（RNFL）、总视网膜（TRT）、视网膜神经节细胞层（RGCL）、内丛状层（IPL）、光感受器层（PL）和脉络膜厚度。
在 3 个月时，未接受 CPAP 治疗的患者内侧鼻侧黄斑节段的 RGCL 厚度减少（P=0.016）。在接受 CPAP 治疗的患者中，RNFL 厚度（5/6 个节段）和 TRT（7/9 个节段）增加，而脉络膜变薄（P=0.003）。在基线时，检测到脉络膜厚度与 AHI 之间存在正相关（r=0.352，P=0.005），以及 IPL 厚度（7/9 个节段）与 AHI 之间存在正相关（r=0.414，P<0.001）。
在 3 个月的时间里，初始的视网膜和脉络膜增厚后出现 RGCL 变薄。在接受 CPAP 治疗的患者中，我们观察到没有任何视网膜层变薄，脉络膜厚度恢复正常。
