Mojon D S, Mathis J, Zulauf M, Koerner F, Hess C W
Department of Ophthalmology, University of Bern, Switzerland.
Ophthalmology. 1998 May;105(5):874-7. doi: 10.1016/S0161-6420(98)95030-8.
The study aimed to determine ocular abnormalities in sleep apnea syndrome (SAS), an entity characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of cardiovascular and neurologic sequelae.
The study design was a case series.
Nine patients referred for evaluation of suspected SAS participated.
Complete ophthalmologic examination, including computerized perimetry, was performed.
Correlations between the respiratory disturbance index (RDI) during night sleep, a value used to diagnose and to grade SAS, and visual field indices using the Spearman rank correlation coefficient (r(s)) were measured.
One patient was excluded from the statistical analysis because of optic nerve drusen with constricted visual fields, another because of tilted discs with corresponding temporal visual field defects. All three patients with severe SAS and one patient with moderate SAS had relative nasal arcuate visual field defects; two patients with severe SAS also had paracentral relative defects. One patient with normal polysomnographic result and two patients with mild or moderate SAS had normal visual fields. The RDI correlated positively with the mean visual field defect (r(s) = 0.81, P < 0.05) and with the visual field loss variance (r(s) = 0.78, P < 0.05). The clinical ophthalmologic examination results were normal in all seven patients. In two of the three patients with severe SAS treated with continuous positive airway pressure (CPAP), visual field defects remained stable over 18 months. The patient with optic nerve drusen also had severe SAS and was, therefore, treated with CPAP. His constricted visual fields improved dramatically after treatment.
Visual fields of patients with SAS showed defects consistent with an optic neuropathy. The CPAP therapy seems to stabilize or even reverse visual field defects.
本研究旨在确定睡眠呼吸暂停综合征（SAS）患者的眼部异常情况。SAS的特征是睡眠期间反复出现上呼吸道阻塞，导致缺氧和睡眠中断，并伴有心血管和神经后遗症风险。
本研究设计为病例系列研究。
9名因疑似SAS前来评估的患者参与了研究。
进行了包括电脑视野计检查在内的全面眼科检查。
测量夜间睡眠期间的呼吸紊乱指数（RDI，用于诊断和分级SAS的指标）与视野指数之间的相关性，采用Spearman等级相关系数（r(s)）。
一名因视神经玻璃疣伴视野缩窄的患者被排除在统计分析之外，另一名因视盘倾斜伴相应颞侧视野缺损的患者被排除。所有3名重度SAS患者和1名中度SAS患者均有相对的鼻侧弓形视野缺损；2名重度SAS患者还伴有旁中心相对缺损。1名多导睡眠图结果正常的患者以及2名轻度或中度SAS患者视野正常。RDI与平均视野缺损呈正相关（r(s)=0.81，P<0.05），与视野损失方差也呈正相关（r(s)=0.
