de Terán Teresa Diaz, Boira Ignacio, Cerveró Andrea, Casado Alfonso, Lopez-de-Eguileta Alicia, Fonseca Soraya, Muñoz Pedro, Nebot Claudia, Nicolini Antonello, Banfi Paolo, Solidoro Paolo, González Mónica
Department of Pneumology, Sleep and Non-Invasive Ventilation Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain.
University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain.
Sleep Breath. 2025 Apr 30;29(2):173. doi: 10.1007/s11325-025-03336-w.
The purpose of our study was to evaluate the effectiveness of CPAP in increasing the thickness of retinal layers. Other aims were to assess retinal and optic nerve damage predictors in OSA and establish predictors of poor response to CPAP treatment in optic nerve damage.
A prospective cohort study with consecutive inclusion of the first 3 patients who attended for treatment each day. All patients underwent a diagnostic polygraph, and patients with moderate-severe OSA treated with CPAP were recruited. Optical Coherence Tomography (OCT) was performed within 3 days of the patient's inclusion and 12 months after the start of CPAP treatment.
Data from 37 patients with OSA were analysed. After 12 months of CPAP treatment, there was a significant improvement in the thickness of the superotemporal Bruch's membrane opening-minimum rim width (BMO-MRW) (316.54 to 318.23 μm, p-value = 0.08). There was a non-significant improvement in the thickness of nasal, inferonasal and superonasal retinal nerve fibre layers. In a multivariate analysis, HB and Type 2 diabetes mellitus have been associated with an increased odds ratio (OR) of retinal and optical nerve damage (OR = 3.58, p = 0.03 and OR = 4.344, p = 0.042, respectively).
BMO-MRW thickness may assess early damage induced by OSA and the response to CPAP. HB is a predictor of retinal and optic nerve damage in patients with OSA. CPAP treatment has a long-term protective effect on the retina and optic nerve.
我们研究的目的是评估持续气道正压通气（CPAP）增加视网膜层厚度的有效性。其他目的是评估阻塞性睡眠呼吸暂停（OSA）中视网膜和视神经损伤的预测因素，并确定视神经损伤对CPAP治疗反应不佳的预测因素。
一项前瞻性队列研究，连续纳入每天前来治疗的前3名患者。所有患者均接受诊断性多导睡眠监测，并招募接受CPAP治疗的中重度OSA患者。在患者入组后3天内及CPAP治疗开始后12个月进行光学相干断层扫描（OCT）。
分析了37例OSA患者的数据。CPAP治疗12个月后，颞上布鲁赫膜开口-最小边缘宽度（BMO-MRW）厚度有显著改善（从316.54μm增至318.23μm，p值=0.08）。鼻侧、鼻下和鼻上视网膜神经纤维层厚度有不显著的改善。在多变量分析中，血红蛋白（HB）和2型糖尿病与视网膜和视神经损伤的比值比（OR）增加相关（OR分别为3.58，p=0.03和OR为4.344，p=0.042）。
BMO-MRW厚度可评估OSA引起的早期损伤及对CPAP的反应。HB是OSA患者视网膜和视神经损伤的预测因素。CPAP治疗对视网膜和视神经有长期保护作用。
