Lin Pei-Wen, Chiu Li-Wen, Chang Chun-Tuan, Lin Hsin-Ching
Division of Glaucoma, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Sleep Centre, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
J Sleep Res. 2025 Aug;34(4):e14422. doi: 10.1111/jsr.14422. Epub 2024 Nov 27.
This study prospectively analysed the difference in the blood flow of the optic nerve head (ONH) between patients with obstructive sleep apnea/hypopnea syndrome (OSA) and control subjects by laser speckle flowgraphy (LSFG), and determined the correlations between LSFG variables and the severity of OSA. A total of 100 participants consecutively underwent full-night polysomnography, ophthalmologic examinations, and LSFG measurements. The LSFG parameters were summarised as the mean blur rate in all areas of the ONH (MA), in the big vessel area of ONH (MV), and in the tissue area of ONH (MT). When the control (17 subjects) and patients with mild/moderate OSA (42 patients) were grouped together and compared with patients with severe OSA (41 patients), the MA, MV, and MT were decreased significantly in patients with severe OSA compared with control subjects and patients with mild/moderate OSA (p < 0.0001, p = 0.0001, and p = 0.0034, respectively). Negative correlations were identified between the apnea-hypopnea index and MA (ρ = -0.244, p = 0.0016), between AHI and MV (ρ = -0.263, p = 0.0006), and between AHI and MT (ρ = -0.198, p = 0.0105). Positive correlations were identified between the lowest saturation of oxygen (LSaO) and MA (ρ = 0.332, p < 0.0001), between LSaO and MV (ρ = 0.354, p < 0.0001), and between LSaO and MT (ρ = 0.227, p = 0.0035). Our study demonstrated that OSA could have a negative impact on the microcirculation of the optic nerve head, including MA, MV, and MT measurements. Furthermore, the decreased blood flow of the optic nerve head obviously correlated with the severity of OSA.
本研究采用激光散斑血流图（LSFG）前瞻性分析阻塞性睡眠呼吸暂停/低通气综合征（OSA）患者与对照者视神经乳头（ONH）血流的差异，并确定LSFG变量与OSA严重程度之间的相关性。共有100名参与者连续接受了全夜多导睡眠监测、眼科检查和LSFG测量。LSFG参数总结为ONH所有区域的平均模糊率（MA）、ONH大血管区域的平均模糊率（MV）和ONH组织区域的平均模糊率（MT）。将对照组（17名受试者）和轻度/中度OSA患者（42例）归为一组，并与重度OSA患者（41例）进行比较，结果显示重度OSA患者的MA、MV和MT均显著低于对照组和轻度/中度OSA患者（分别为p < 0.0001、p = 0.0001和p = 0.0034）。呼吸暂停低通气指数与MA之间呈负相关（ρ = -0.244，p = 0.0016），与MV之间呈负相关（ρ = -0.263，p = 0.0006），与MT之间呈负相关（ρ = -0.198，p = 0.0105）。最低血氧饱和度（LSaO）与MA之间呈正相关（ρ = 0.332，p < 0.0001），与MV之间呈正相关（ρ = 0.354，p < 0.0001），与MT之间呈正相关（ρ = 0.227，p = 0.0035）。我们的研究表明，OSA可能对视神经乳头的微循环产生负面影响，包括MA、MV和MT测量值。此外，视神经乳头血流减少明显与OSA的严重程度相关。
