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RETINAL NERVE FIBER LAYER ANALYSIS IN OBSTRUCTIVE SLEEP APNEA

Year 2018, Volume: 32 Issue: 1, 33 - 39, 18.05.2018
https://doi.org/10.5505/deutfd.2017.87487

Abstract

Objective:
To investigate the retinal nerve fiber thickness
(RNFL) in patients with Obstructive sleep apnea syndrome (OSAS) and to
determine the correlation of ocular changes with the severity of disease.



Material
and Methods:
21 patients with Respiratory Disturbance Index (RDI)
between 5-29 were included in group 1 and
33 patients with RDI > 29 in
group 2. Patients received RNFL measurement with optical coherence tomography
(OCT). The difference between the groups and the correlation of RFNL with RDI,
mean and minimum O2 saturation was evaluated.

Results: The
mean RNFL was 117.33±7.57 in group 1, 111.91 ±8.64 μm in group2. There was
statistically significant difference (p=0.023). RNFL in inferior quadrant was
147.95 ±12.97 for group 1, 137.27±17.94 μm for group 2. The difference was
statistically significant (p=0.032). Mean RNFL was correlated with RDI
.



Conclusion: There is a significant decreare in RFNL occur in
patients with OSAS and changes show correlation with severity of disease.
Awareness of relationship helps ophthalmologists to question their patients in
terms of OSAS symptoms.

References

  • Young T, Patla M, Dempsey J, Skatrud J, Weber S, Badr S. The occurence of sleep disordered breathing among middle aged adults. N England J Med 1993; 328:1230-5.
  • Gislason T, Benediktsdottir B, Bjornsson JK, Kjartansson G, Kjeld M, Kristbjar- narson H. Snoring, hypertension and the sleep apnea sydrome: an epidemiologic survey of middle-aged women. Chest 1993;103:1147-51.
  • Mojon DS, Goldblum D, Fleischhauer J, et al. Eyelid, conjunctival and corneal findings in sleep apnea syndrome. Ophthalmology 1999;106:1182-5.
  • Mojon DS, Hess CW, Goldblum D, et al. Normal tension glaucoma is associated with sleep apnea syndrome. Ophthalmologica 2002;216:180-4.
  • Mojon DS, Hess CW, Goldblum D, et al. High prevalence of glaucoma in patients with sleep apnea syndrome. Ophthalmology 1999;106:1009-12.
  • Mojon DS, Hedges TR, Ehrenberg B, et al. Association between sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy. Arch Ophthalmol 2002;120(5):601–5.
  • Walsh JT, Montplaisir J. Familial glaucoma with sleep apnoea: a new syndrome? Thorax 1982;37:845-9.
  • Sergi M, Salerno DE, Rizzi M et al. Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma 2007;16:42-6.
  • Lin PW, Friedman MW, Lin HC, Chang HW, Wilson M, Lin MC. Normal tension glaucoma in patients with obstructive sleep apnea/hypopnea syndrome. J Glaucoma 2011;20:553-8.
  • Bendel RE, Kaplan J, Heckman M, Fredrickson PA, Lin SC. Prevalence of glaucoma in patients with obstructive sleep apnoea – a cross-sectional caseseries. Eye 2008; 22:1105-9.
  • Karakucuk S, Goktas S, Aksu M et al. Ocular blood flow in patients with obstructive sleep apnea syndrome (OSAS). Graefes Arch Clin Exp Ophthalmol 2008;246:129-34.
  • Klein BE, Klein R, Sponsel WE, et al.Prevalence of glaucoma: The Beaver Dam Eye Study. Ophthalmology 1992;99:1499-504.
  • Geyer O, Cohen N, Segev E, et al. The prevalence of glaucoma in patients with sleep apnea syndrome: same as in the general population. Am J Ophthalmol 2003;136:1093-6.
  • Stein JD, Kim DS, Mundy KM, et al. The association between glaucomatous and other causes of optic neuropathy and sleep apnea. Am J Ophthalmol 2011;152: 989-98.
  • Girkin CA, McGwin G Jr, McNeal SF, Owsley C. Is there an association between pre-existing sleep apnoea and the development of glaucoma? Br J Ophthalmol 2006; 90:679–81.
  • Tsang CSL, Chong SL, Ho CK, Li MF. Moderate to severe obstructive sleep apnoea patients is associated with a higher incidence of visual field defect. Eye 2006;20:38-42.
  • Caprioli J, Coleman AL. Perspective: blood pressure, perfusion pressure, and glaucoma. Am J Ophthalmol 2010; 149: 704-12.
  • Lee VW, Hei Mok K. Retinal nerve fibre layer measurement by nerve fibre analyzer in normal subjects and patients with glaucoma. Ophthalmology 1999; 106:1006 -8.
  • Quigley HA, Dunkelberger GR, Green WR. Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol 1989;107:453-64.
  • Kargi SH, Altin R, Koksal M et al. Retinal nerve fibre layer measurements are reduced in patients with obstructive sleep apnoea syndrome. Eye 2005;19:575-79.
  • Shiba T, Takahashi M, Sato Y et al. Relationship between Severity of Obstructive Sleep Apnea Syndrome and Retinal Nerve Fiber Layer Thickness. Am J Ophthalmol 2014:157:1202-8.
  • Lin PW, Friedman M, LinHC et al. Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome. Arch Clin Exp Ophthalmol 2011; 249:585-93.
  • Karaca EE, Aktas Z, Ekıcı F, Hasanreisoglu M, Ozdek S, Cıftcı UT. Obstrüktif Uyku Apne Sendromlu Olgularda Retina Sinir Lifi Analizi ve Santral Korneal Kalınlık Parametrelerinin Değerlendirilmesi. Glokom-Katarakt 2015;10:37-40
  • Zhao XJ, Yang C, Zhang J, et al. Obstructive sleep apnea and retinal nerve fiber layer thickness: a meta-analysis. J Glaucoma 2016; 25:e413–418. Sun CL, Zhou LX, Dang Y, Huo YP, Shi L, Chang YJ Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea syndrome: A meta-analysis. Medicine (Baltimore) 2016;95:e4499.

Obstrüktif uyku apne sendromunda retina sinir lifi analizi

Year 2018, Volume: 32 Issue: 1, 33 - 39, 18.05.2018
https://doi.org/10.5505/deutfd.2017.87487

Abstract

Amaç: Obstrüktif uyku apne sendromu
(OUAS) hastalarını retina sinir lifi tabakası (RSLT) kalınlıkları yönünden
incelemek ve oküler değişikliklerin hastalığın şiddeti ile ilişkisini
belirlemek.



Gereç ve Yöntem: OUAS tanılı 54 hasta göz bulguları açısından
değerlendirildi.
Respiratory Disturbance Index-Anormal Solunum Olayı İndeksi (RDI) 5-29
olan 21’i grup 1, RDI>29 olan 33’
ü ise grup 2 kapsamında
sınıflandırıldı. Hastalara
Optik Koherens
Tomografi
(OKT) ile RSLT
ölçümleri yapıldı. Gruplar elde edilen veriler açısından karşılaştırılırken,
verilerin RDI, ortalama ve minimum O2 satürasyonu ile olan
ilişkileri de incelendi.



Bulgular: Ortalama RSLT grup 1’de 117,33±7,57 μm, grup 2’de ise 111,91
±8,64 μm olarak ölçüldü.  RSLT’deki
incelme istatistiksel olarak anlamlı bulundu (p=0,023). İnferior RSLT grup 1’de
147,95 ±12,97 μm, grup 2’de 137,27±17,94 μm olarak bulundu. Grup 2’deki incelme
istatistiksel olarak anlamlı bulundu (p=0,032). Ortalama RSLT ile RDI arasında
negatif korelasyon saptandı
.



Sonuç:
OUAS hastalarında RSLT kalınlığında azalma meydana gelmekte ve bu
değişimler OUAS’ın ağırlığı ile korelasyon göstermektedir. Bu iki durum
arasındaki ilişkinin bilinmesi hastaların öncelikle göz hekimi tarafından
görüldüklerinde olası OUAS semptomları yönünden sorgulanmalarına olanak
sağlayacaktır.

References

  • Young T, Patla M, Dempsey J, Skatrud J, Weber S, Badr S. The occurence of sleep disordered breathing among middle aged adults. N England J Med 1993; 328:1230-5.
  • Gislason T, Benediktsdottir B, Bjornsson JK, Kjartansson G, Kjeld M, Kristbjar- narson H. Snoring, hypertension and the sleep apnea sydrome: an epidemiologic survey of middle-aged women. Chest 1993;103:1147-51.
  • Mojon DS, Goldblum D, Fleischhauer J, et al. Eyelid, conjunctival and corneal findings in sleep apnea syndrome. Ophthalmology 1999;106:1182-5.
  • Mojon DS, Hess CW, Goldblum D, et al. Normal tension glaucoma is associated with sleep apnea syndrome. Ophthalmologica 2002;216:180-4.
  • Mojon DS, Hess CW, Goldblum D, et al. High prevalence of glaucoma in patients with sleep apnea syndrome. Ophthalmology 1999;106:1009-12.
  • Mojon DS, Hedges TR, Ehrenberg B, et al. Association between sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy. Arch Ophthalmol 2002;120(5):601–5.
  • Walsh JT, Montplaisir J. Familial glaucoma with sleep apnoea: a new syndrome? Thorax 1982;37:845-9.
  • Sergi M, Salerno DE, Rizzi M et al. Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma 2007;16:42-6.
  • Lin PW, Friedman MW, Lin HC, Chang HW, Wilson M, Lin MC. Normal tension glaucoma in patients with obstructive sleep apnea/hypopnea syndrome. J Glaucoma 2011;20:553-8.
  • Bendel RE, Kaplan J, Heckman M, Fredrickson PA, Lin SC. Prevalence of glaucoma in patients with obstructive sleep apnoea – a cross-sectional caseseries. Eye 2008; 22:1105-9.
  • Karakucuk S, Goktas S, Aksu M et al. Ocular blood flow in patients with obstructive sleep apnea syndrome (OSAS). Graefes Arch Clin Exp Ophthalmol 2008;246:129-34.
  • Klein BE, Klein R, Sponsel WE, et al.Prevalence of glaucoma: The Beaver Dam Eye Study. Ophthalmology 1992;99:1499-504.
  • Geyer O, Cohen N, Segev E, et al. The prevalence of glaucoma in patients with sleep apnea syndrome: same as in the general population. Am J Ophthalmol 2003;136:1093-6.
  • Stein JD, Kim DS, Mundy KM, et al. The association between glaucomatous and other causes of optic neuropathy and sleep apnea. Am J Ophthalmol 2011;152: 989-98.
  • Girkin CA, McGwin G Jr, McNeal SF, Owsley C. Is there an association between pre-existing sleep apnoea and the development of glaucoma? Br J Ophthalmol 2006; 90:679–81.
  • Tsang CSL, Chong SL, Ho CK, Li MF. Moderate to severe obstructive sleep apnoea patients is associated with a higher incidence of visual field defect. Eye 2006;20:38-42.
  • Caprioli J, Coleman AL. Perspective: blood pressure, perfusion pressure, and glaucoma. Am J Ophthalmol 2010; 149: 704-12.
  • Lee VW, Hei Mok K. Retinal nerve fibre layer measurement by nerve fibre analyzer in normal subjects and patients with glaucoma. Ophthalmology 1999; 106:1006 -8.
  • Quigley HA, Dunkelberger GR, Green WR. Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol 1989;107:453-64.
  • Kargi SH, Altin R, Koksal M et al. Retinal nerve fibre layer measurements are reduced in patients with obstructive sleep apnoea syndrome. Eye 2005;19:575-79.
  • Shiba T, Takahashi M, Sato Y et al. Relationship between Severity of Obstructive Sleep Apnea Syndrome and Retinal Nerve Fiber Layer Thickness. Am J Ophthalmol 2014:157:1202-8.
  • Lin PW, Friedman M, LinHC et al. Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome. Arch Clin Exp Ophthalmol 2011; 249:585-93.
  • Karaca EE, Aktas Z, Ekıcı F, Hasanreisoglu M, Ozdek S, Cıftcı UT. Obstrüktif Uyku Apne Sendromlu Olgularda Retina Sinir Lifi Analizi ve Santral Korneal Kalınlık Parametrelerinin Değerlendirilmesi. Glokom-Katarakt 2015;10:37-40
  • Zhao XJ, Yang C, Zhang J, et al. Obstructive sleep apnea and retinal nerve fiber layer thickness: a meta-analysis. J Glaucoma 2016; 25:e413–418. Sun CL, Zhou LX, Dang Y, Huo YP, Shi L, Chang YJ Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea syndrome: A meta-analysis. Medicine (Baltimore) 2016;95:e4499.
There are 24 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Rukiye Aydın 0000-0003-0668-3749

Funda Dikkaya This is me

Rengin Yıldırım This is me

Publication Date May 18, 2018
Submission Date September 11, 2017
Published in Issue Year 2018 Volume: 32 Issue: 1

Cite

Vancouver Aydın R, Dikkaya F, Yıldırım R. Obstrüktif uyku apne sendromunda retina sinir lifi analizi. DEU Tıp Derg. 2018;32(1):33-9.