Eye Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Pz.Le LA Scuro 10, 37100, Verona, VR, Italy.
Pediatric Division, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Piazzale Stefani 1, 37126, Verona, VR, Italy.
Int Ophthalmol. 2022 Apr;42(4):1281-1287. doi: 10.1007/s10792-021-02115-2. Epub 2021 Nov 5.
The relation between OSAS and eye diseases is well known in adults, while very few and contradictory data can be found regarding paediatric ages. The aim of this study is to explore the early corneal, macular and optic nerve changes in paediatric patients with OSAS.
Prospective study that enrolled children aged ≥ 4 years referred to the Paediatric Pneumology Clinic in Verona for suspected obstructive sleep apnoea syndrome (OSAS) and investigated with the overnight respiratory polygraphy. Patients with apnoea-hypopnea index (AHI) > 1 were classified as OSAS, while those with AHI < 1 were classified non-OSAS. All patients underwent comprehensive eye examination including slit lamp, refraction, intraocular pression (Goldman applanation tonometry), corneal tomography (corneal astigmatism, corneal keratometry at the apex, surface asymmetry index, central corneal thickness and thinnest corneal thickness) and optical coherence tomography (central macular thickness, macular volume and retinal nerve fibre layer).
Seventy-two children were enrolled in the study. The overall prevalence of OSAS was 48.6%. Statistically significant differences were found between OSAS and non-OSAS group for corneal asymmetry (0.9 ± 0.5 and 0.6 ± 0.3, respectively; p = 0.02), thinnest corneal thickness (551.8 ± 33.9 and 563.7 ± 32.5; p = 0.04), average retinal nerve fibre layer (102.8 ± 10.5 µm and 98.1 ± 12.3 µm; p = 0.012) and in nasal quadrant (76.2 ± 15.4 µm and 66.5 ± 12.6 µm; p = 0.0002).
A comprehensive eye examination with corneal and optic nerve imaging showed early corneal and optic nerve changes in children newly diagnosed with OSAS. These could be prelude of the known ocular manifestations associated with OSAS in adult patients.
阻塞性睡眠呼吸暂停综合征（OSAS）与眼部疾病的关系在成人中已得到广泛证实，而关于儿科患者的相关数据则非常有限且相互矛盾。本研究旨在探讨儿科 OSAS 患者的早期角膜、黄斑和视神经变化。
前瞻性研究纳入了年龄≥4 岁、因疑似阻塞性睡眠呼吸暂停综合征（OSAS）而被转诊到维罗纳儿科肺病诊所的儿童。这些患儿均接受了过夜呼吸多导睡眠图检查。呼吸暂停低通气指数（AHI）＞1 的患儿被归类为 OSAS 组，而 AHI＜1 的患儿则被归类为非 OSAS 组。所有患者均接受了全面的眼部检查，包括裂隙灯检查、屈光检查、眼压（Goldman 压平眼压计）、角膜断层扫描（角膜散光、角膜顶点角膜曲率、表面不对称指数、中央角膜厚度和最薄角膜厚度）和光学相干断层扫描（中央黄斑厚度、黄斑体积和视网膜神经纤维层）。
本研究共纳入 72 例患儿。OSAS 的总体患病率为 48.6%。OSAS 组与非 OSAS 组在角膜不对称性（分别为 0.9±0.5 和 0.6±0.3；p=0.02）、最薄角膜厚度（分别为 551.8±33.9 和 563.7±32.5；p=0.04）、平均视网膜神经纤维层（分别为 102.8±10.5 µm 和 98.1±12.3 µm；p=0.012）以及鼻象限（分别为 76.2±15.4 µm 和 66.5±12.6 µm；p=0.0002）方面存在统计学显著差异。
对新诊断为 OSAS 的儿童进行全面的眼部检查和视神经成像检查显示，这些患儿的角膜和视神经已经出现早期改变。这些改变可能是成人 OSAS 相关眼部表现的先兆。
