哥伦比亚人群中阻塞性睡眠呼吸暂停患者的原发性开角型青光眼：一项横断面研究。

Primary open-angle glaucoma in patients with obstructive sleep apnoea in a Colombian population: a cross-sectional study.

机构信息

Ophthalmology and Glaucoma Department, Hospital Militar Central, Bogota, Colombia

School of Medicine, Universidad Militar Nueva Granada, Bogota, Colombia.

出版信息

BMJ Open. 2023 Feb 22;13(2):e063506. doi: 10.1136/bmjopen-2022-063506.

DOI:10.1136/bmjopen-2022-063506

PMID:36813489

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9950889/

Abstract

OBJECTIVE

Determine the prevalence, functional and structural alterations of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnoea (OSA).

DESIGN

Cross-sectional.

SETTING

Tertiary hospital associated with specialised center in ophthalmologic images in Bogota, Colombia.

PARTICIPANTS

150 patients, for a sample of 300 eyes, 64 women (42.7%) and 84 men (57.3%) between 40 and 91 years old with a mean age of 66.8 (±12.1) years.

INTERVENTIONS

Visual acuity, biomicroscopy, intraocular pressure, indirect gonioscopy and direct ophthalmoscopy. Patients classified as glaucoma suspects underwent automated perimetry (AP) and optical coherence tomography of the optic nerve OUTCOME MEASURE: The primary outcomes are the determination of prevalence of glaucoma suspects and POAG in patients with OSA. Secondary outcomes are the description of functional and structural alterations in computerised exams of patients with OSA.

RESULTS

The prevalence of glaucoma suspect was 12.6%, and for POAG was 17.3%. No alterations in the appearance of the optic nerve was seen in 74.6%, focal or diffuse thinning of the neuroretinal rim (16.6%) was the most frequently finding, followed by asymmetry of the disc>0.2 mm (8.6%) (p=0.005). In the AP, 41% showed arcuate, nasal step and paracentral focal defects. The mean retinal nerve fiber layer (RNFL) was normal (>80 µM) in 74% of the mild OSA group, 93.8% of the moderate group and 17.1% of the severe group. Similarly, normal (P5-90) ganglion cell complex (GCC) in 60%, 68% and 75%, respectively. Abnormal results in the mean RNFL was seen in 25.9%, 6.3% and 23.4% of the mild, moderate and severe groups, respectively. In the GCC, 39.7%, 33.3% and 25% of the patients in the aforementioned groups.

CONCLUSION

It was possible to determine the relationship between structural changes in the optic nerve and the severity of OSA. No relationship with any of the other studied variables was identified.

摘要

目的

确定阻塞性睡眠呼吸暂停（OSA）患者原发性开角型青光眼（POAG）的患病率、功能和结构改变。

设计

横断面研究。

地点

哥伦比亚波哥大与眼科影像专科中心相关的三级医院。

参与者

150 名患者，共 300 只眼，64 名女性（42.7%）和 84 名男性（57.3%），年龄 40 至 91 岁，平均年龄 66.8（±12.1）岁。

干预措施

视力、生物显微镜检查、眼压、间接房角镜检查和直接检眼镜检查。将青光眼疑似患者分类为接受自动视野检查（AP）和视神经光学相干断层扫描。

主要结局

确定 OSA 患者中青光眼疑似患者和 POAG 的患病率。次要结局是描述 OSA 患者计算机检查的功能和结构改变。

结果

青光眼疑似患者的患病率为 12.6%，POAG 患病率为 17.3%。74.6%的视神经外观无改变，神经视网膜边缘局灶或弥漫性变薄（16.6%）最常见，其次是盘不对称>0.2 mm（8.6%）（p=0.005）。AP 中，41%显示弓形、鼻侧步和旁中心局灶性缺损。轻度 OSA 组 74%、中度组 93.8%和重度组 17.1%的平均视网膜神经纤维层（RNFL）正常（>80 µM）。同样，轻度、中度和重度组的正常（P5-90）节细胞复合体（GCC）分别为 60%、68%和 75%。轻度、中度和重度组的平均 RNFL 异常分别为 25.9%、6.3%和 23.4%。在 GCC 中，上述各组中分别有 39.7%、33.3%和 25%的患者。