Department of Ophthalmology, Huadong Sanatorium, Wuxi, China.
Department of Otolaryngology, Wuxi Huishan District People's Hospital, Luoshe Town, Huishan District, Wuxi, China.
J Clin Sleep Med. 2023 Mar 1;19(3):479-490. doi: 10.5664/jcsm.10370.
We performed a case-control study to investigate the correlation between the apnea-hypopnea index (AHI) and the retinal vascular fractal dimension (FD).
We selected 527 individuals who underwent polysomnography during health checkups at the Huadong Sanatorium from January to December 2021 as the study population, of whom 468 were included and 59 were excluded. All participants underwent a detailed health examination, including medical history assessment, physical examination, assessment of lifestyle factors, fundus photography, and laboratory examinations. The retinal vasculature was quantitatively assessed using Singapore I Vessel Assessment (SIVA) software. The relationship between the AHI and the retinal vessel quantitative was examined by multiple linear regression analyses and restricted cubic spline.
Among the 468 studied individuals, the average age was 51.51 (43-58) years, with 369 (78.85%) men and 99 (21.15%) women. According to the AHI indicator, 355 individuals were diagnosed with obstructive sleep apnea (OSA) syndrome, with an average AHI of 17.00 (9.200-30.130) events/h; 113 individuals were classified as controls, with an average AHI of 2.13 (0.88-3.63) events/h. In multiple linear regression, following varying degrees of adjustment for confounding factors, FD was reduced by 0.013 ( = .012; 95% confidence interval [CI]: -0.024 to -0.003), FD arteriole (FDa) was reduced by 0.013 ( = .019; 95% CI: -0.024 to -0.002), and FD venule (FDv) was reduced by 0.014 ( = .08; 95% CI: -0.024 to -0.004) in the high-AHI group compared with the low-AHI group. All tests for trend values were < .05. The restricted cubic spline in the overall OSA population and the individuals without diabetes revealed a U-shaped pattern of decreasing, then increasing, FD, FDa, and FDv with a rising AHI. In the OSA individual with diabetes, FD, FDa, and FDv gradually decreased with increasing AHI.
The FD is associated with AHI in OSA individuals. The link between AHI and FD varied for OSA individuals with and without diabetes.
Wang J, Chen T, Qi X, Li Y, Yang X, Meng X. Retinal vascular fractal dimension measurements in patients with obstructive sleep apnea syndrome: a retrospective case-control study. . 2023;19(3):479-490.
我们进行了一项病例对照研究，旨在探讨呼吸暂停-低通气指数（AHI）与视网膜血管分形维数（FD）之间的相关性。
我们选取了 2021 年 1 月至 12 月在华东疗养院进行健康检查时接受多导睡眠图检查的 527 名个体作为研究人群，其中 468 名被纳入研究，59 名被排除。所有参与者均接受了详细的健康检查，包括病史评估、体格检查、生活方式因素评估、眼底摄影和实验室检查。使用新加坡血管评估（SIVA）软件对视网膜血管进行定量评估。采用多元线性回归分析和限制立方样条函数对 AHI 与视网膜血管定量之间的关系进行检验。
在 468 名研究对象中，平均年龄为 51.51（43-58）岁，其中 369 名（78.85%）为男性，99 名（21.15%）为女性。根据 AHI 指标，355 名个体被诊断为阻塞性睡眠呼吸暂停（OSA）综合征，平均 AHI 为 17.00（9.200-30.130）次/小时；113 名个体被归类为对照组，平均 AHI 为 2.13（0.88-3.63）次/小时。在多元线性回归中，在对混杂因素进行不同程度的调整后，高 AHI 组的 FD 降低了 0.013（ =.012；95%置信区间 [CI]：-0.024 至 -0.003），FD 小动脉（FDa）降低了 0.013（ =.019；95% CI：-0.024 至 -0.002），FD 小静脉（FDv）降低了 0.014（ =.08；95% CI：-0.024 至 -0.004）。所有趋势 值检验均<.05。在整个 OSA 人群和无糖尿病个体中，受限立方样条显示，随着 AHI 的升高，FD、FDa 和 FDv 呈先降低后升高的 U 形模式。在患有糖尿病的 OSA 个体中，FD、FDa 和 FDv 随着 AHI 的升高逐渐降低。
FD 与 OSA 个体的 AHI 相关。AHI 与 FD 的关系因有无糖尿病的 OSA 个体而异。
Wang J, Chen T, Qi X, Li Y, Yang X, Meng X. 阻塞性睡眠呼吸暂停综合征患者的视网膜血管分形维数测量：一项回顾性病例对照研究。. 2023;19(3):479-490.
