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Obstructive sleep apnea syndrome and blood flow to the eyes

Year 2013, Volume: 18 Issue: 4, 165 - 171, 14.03.2014

Abstract

Abstract. To evaluate the pulsatile ocular blood flow (POBF) in patients with obstructive sleep apnea syndrome (OSAS). Forty-one newly diagnosed OSAS patients without comorbidities and 17 healthy control subjects were included to the study. Subjects were classified into groups of control, mild- moderate OSAS and severe OSAS, based on apnea–hypopnea index (AHI) values as control [AHI=<5 h(-1)), mild-moderate [AHI= 5-30 h(-1)], and severe [AHI >30 h(-1)]. For each eye, the Ocular Blood Flow Analyzer was used to obtain measurements of POBF. This study included 41 patients (10 female, 31 male) and 17 controls (6 female, 11 male). Cases and controls were comparable in body mass index, sex, and age. No statistical difference was found between the groups of patients with OSAS and healthy control subjects in age, BMI, sex, ocular axial length, IOP and mean blood pressure. There was no significant difference between control and OSAS patients in terms of POBF (T-test; p>0.05). There was no significant difference between groups in terms of POBF (one way ANOVA; p=0.3). In severe OSAS group, no statistically significant correlation was found between AHI and POBF(r= 0.09, p=0.5). These data show that the OSAS patients exhibit no significant difference in POBF compared to control group.

Key words: Intraocular pressure, obstructive sleep apnea syndrome, ocular blood flow, pulsatile ocular blood flow

 

References

  • Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-143.
  • Wilcox PG, Paré PD, Road JD, Fleetham JA. Respiratory muscle function during obstructive sleep apnea. Am Rev Respir Dis 1990; 142: 533-539.
  • Caples SM, Garcia-Touchard A, Somers VK. Sleepdisordered breathing and cardiovascular risk. Sleep 2007; 30: 291-303.
  • Lévy P, Pépin JL, Arnaud C, et al. Obstructive sleep apnea and atherosclerosis. Prog Cardiovasc Dis 2009; 51: 400-410.
  • Foster GE, Poulin MJ, Hanly PJ. Intermittent hypoxia and vascular function: implications for obstructive sleep apnoea. Exp Physiol 2007; 92: 51
  • McNab AA. Floppy eyelid syndrome and obstructive sleep apnea. Ophthal Plast Reconstr Surg 1997; 13: 98Mojon DS, Goldblum D, Fleischhauer J, et al. Eyelid, conjunctival, and corneal findings in sleep apnea syndrome. Ophthalmology 1999; 106: 118211
  • Bucci FA Jr, Krohel GB. Optic nerve swelling secondary to the obstructive sleep apnea syndrome. Am J Ophthalmol 1988; 105: 428-430.
  • Mojon DS, Mathis J, Zulauf M, Koerner F, Hess CW. Optic neuropathy associated with sleep apnea syndrome. Ophthalmology 1998; 105: 874-877.
  • Kargi SH, Altin R, Koksal M, et al. Retinal nerve fibre layer measurements are reduced in patients with obstructive sleep apnoea syndrome. Eye (Lond) 2005; 19: 575-579.
  • Sergi M, Salerno DE, Rizzi M, et al. Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma 2007; 16 :42-46.
  • Mojon DS, Hess CW, Goldblum D, et al. Normaltension glaucoma is associated with sleep apnea syndrome. Ophthalmologica 2002; 216: 180-184.
  • Palombi K, Renard E, Levy P, et al. Non-arteritic anterior ischaemic optic neuropathy is nearly systematically associated with obstructive sleep apnoea. Br J Ophthalmol 2006; 90: 879-882.
  • 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: 129-134.
  • Nowak MS, Jurowski P, Gos R, Prost ME, Smigielski J. Pulsatile ocular blood flow in subjects with sleep apnoea syndrome. Arch Med Sci 2011; 7:332-336.
  • Langham ME, Farrell RA, O'Brien V, Silver DM, Schilder P. Blood flow in the human eye. Acta Ophthalmol Suppl 1989; 191: 9–13.
  • Yang YC, Hulbert MF, Batterbury M, Clearkin LG. Pulsatile ocular blood flow measurements in healthy eyes: reproducibility and reference values. J Glaucoma 1997; 6: 175–179.
  • Silver D, Geyer O. Pressure-volume relation for the living human eye. Curr Eye Res 2000; 20: 115-120.
  • Alm A. Ocular circulation. In: Moses R, Hart W, eds. Adler’s physiology of the eye; clinical applications. 9th ed. St Louis: C.V Mosby; 1992:198–227.
  • Minoguchi K, Yokoe T, Tazaki T, et al. Increased carotid intima-media thickness and serum inflammatory markers in obstructive sleep apnea. Am J Respir Crit Care Med 2005; 172: 625-630.
  • Dean RT, Wilcox I. Possible atherogenic effects of hypoxia during obstructive sleep apnea. Sleep 1993; 16: 15-21.
  • Lavie L. Obstructive sleep apnoea syndrome--an oxidative stress disorder. Sleep Med Rev 2003; 7: 35Faller DV. Endothelial cell responses to hypoxic stress. Clin Exp Pharmacol Physiol 1999; 26: 74-84.
  • Schulz R, Schmidt D, Blum A, et al. Decreased plasma levels of nitric oxide derivatives in obstructive sleep apnoea: response to CPAP therapy. Thorax 2000; 55: 1046-1051.
  • Kato M, Roberts-Thomson P, Phillips BG, et al. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation 2000; 102: 2607-2610.
  • Bill A, Nilsson SF. Control of ocular blood flow. J Cardiovasc Pharmacol 1985;7: 96-102.
  • Grote L, Kraiczi H, Hedner J. Reduced alpha- and beta(2)-adrenergic vascular response in patients with obstructive sleep apnea. Am J Respir Crit Care Med 2000; 162: 1480-1487.
  • Lavie L, Hefetz A, Luboshitzky R, Lavie P. Plasma levels of nitric oxide and L- arginine in sleep apnea patients: effects of nCPAP treatment. J Mol Neurosci 2003; 21: 57-63.
  • Lam AK, Chan ST, Chan H, Chan B. The effect of age on ocular blood supply determined by pulsatile ocular blood flow and color Doppler ultrasonography. Optom Vis Sci 2003; 80: 305-311.
  • Ravalico G, Toffoli G, Pastori G, Calderini S. Agerelated ocular blood flow changes. Invest Ophthalmol Vis Sci 1996; 37: 2645-2650.
  • Agarwal HC, Gupta V, Sihota R, Singh K. Pulsatile ocular blood flow among normal subjects and patients with high tension glaucoma. Indian J Ophthalmol 2003; 51: 133-8.
  • Kiekens S, Veva De Groot, Coeckelbergh T, et al. "Continuous positive airway pressure therapy is associated with an increase in intraocular pressure in obstructive sleep apnea. Invest Ophthalmol Vis Sci. 2008; 49: 934-40
  • Kiel JW, Shepherd AP. Autoregulation of choroidal blood flow in the rabbit. Invest Ophthalmol Vis Sci 1992; 33: 2399-2410.
  • Trew DR, Smith SE. Postural studies in pulsatile ocular blood flow: II. Chronic open angle glaucoma. Br J Ophthalmol 1991; 75: 71-75.
  • Spraul CW, Lang GE, Ronzani M, Lang GK. Reproducibility of measurements with a nw slit lamp‐mounted ocular blood flow tonograph. Graefes Arch Clin Exp Ophthalmol 1998; 236: 2742
Year 2013, Volume: 18 Issue: 4, 165 - 171, 14.03.2014

Abstract

References

  • Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-143.
  • Wilcox PG, Paré PD, Road JD, Fleetham JA. Respiratory muscle function during obstructive sleep apnea. Am Rev Respir Dis 1990; 142: 533-539.
  • Caples SM, Garcia-Touchard A, Somers VK. Sleepdisordered breathing and cardiovascular risk. Sleep 2007; 30: 291-303.
  • Lévy P, Pépin JL, Arnaud C, et al. Obstructive sleep apnea and atherosclerosis. Prog Cardiovasc Dis 2009; 51: 400-410.
  • Foster GE, Poulin MJ, Hanly PJ. Intermittent hypoxia and vascular function: implications for obstructive sleep apnoea. Exp Physiol 2007; 92: 51
  • McNab AA. Floppy eyelid syndrome and obstructive sleep apnea. Ophthal Plast Reconstr Surg 1997; 13: 98Mojon DS, Goldblum D, Fleischhauer J, et al. Eyelid, conjunctival, and corneal findings in sleep apnea syndrome. Ophthalmology 1999; 106: 118211
  • Bucci FA Jr, Krohel GB. Optic nerve swelling secondary to the obstructive sleep apnea syndrome. Am J Ophthalmol 1988; 105: 428-430.
  • Mojon DS, Mathis J, Zulauf M, Koerner F, Hess CW. Optic neuropathy associated with sleep apnea syndrome. Ophthalmology 1998; 105: 874-877.
  • Kargi SH, Altin R, Koksal M, et al. Retinal nerve fibre layer measurements are reduced in patients with obstructive sleep apnoea syndrome. Eye (Lond) 2005; 19: 575-579.
  • Sergi M, Salerno DE, Rizzi M, et al. Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma 2007; 16 :42-46.
  • Mojon DS, Hess CW, Goldblum D, et al. Normaltension glaucoma is associated with sleep apnea syndrome. Ophthalmologica 2002; 216: 180-184.
  • Palombi K, Renard E, Levy P, et al. Non-arteritic anterior ischaemic optic neuropathy is nearly systematically associated with obstructive sleep apnoea. Br J Ophthalmol 2006; 90: 879-882.
  • 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: 129-134.
  • Nowak MS, Jurowski P, Gos R, Prost ME, Smigielski J. Pulsatile ocular blood flow in subjects with sleep apnoea syndrome. Arch Med Sci 2011; 7:332-336.
  • Langham ME, Farrell RA, O'Brien V, Silver DM, Schilder P. Blood flow in the human eye. Acta Ophthalmol Suppl 1989; 191: 9–13.
  • Yang YC, Hulbert MF, Batterbury M, Clearkin LG. Pulsatile ocular blood flow measurements in healthy eyes: reproducibility and reference values. J Glaucoma 1997; 6: 175–179.
  • Silver D, Geyer O. Pressure-volume relation for the living human eye. Curr Eye Res 2000; 20: 115-120.
  • Alm A. Ocular circulation. In: Moses R, Hart W, eds. Adler’s physiology of the eye; clinical applications. 9th ed. St Louis: C.V Mosby; 1992:198–227.
  • Minoguchi K, Yokoe T, Tazaki T, et al. Increased carotid intima-media thickness and serum inflammatory markers in obstructive sleep apnea. Am J Respir Crit Care Med 2005; 172: 625-630.
  • Dean RT, Wilcox I. Possible atherogenic effects of hypoxia during obstructive sleep apnea. Sleep 1993; 16: 15-21.
  • Lavie L. Obstructive sleep apnoea syndrome--an oxidative stress disorder. Sleep Med Rev 2003; 7: 35Faller DV. Endothelial cell responses to hypoxic stress. Clin Exp Pharmacol Physiol 1999; 26: 74-84.
  • Schulz R, Schmidt D, Blum A, et al. Decreased plasma levels of nitric oxide derivatives in obstructive sleep apnoea: response to CPAP therapy. Thorax 2000; 55: 1046-1051.
  • Kato M, Roberts-Thomson P, Phillips BG, et al. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation 2000; 102: 2607-2610.
  • Bill A, Nilsson SF. Control of ocular blood flow. J Cardiovasc Pharmacol 1985;7: 96-102.
  • Grote L, Kraiczi H, Hedner J. Reduced alpha- and beta(2)-adrenergic vascular response in patients with obstructive sleep apnea. Am J Respir Crit Care Med 2000; 162: 1480-1487.
  • Lavie L, Hefetz A, Luboshitzky R, Lavie P. Plasma levels of nitric oxide and L- arginine in sleep apnea patients: effects of nCPAP treatment. J Mol Neurosci 2003; 21: 57-63.
  • Lam AK, Chan ST, Chan H, Chan B. The effect of age on ocular blood supply determined by pulsatile ocular blood flow and color Doppler ultrasonography. Optom Vis Sci 2003; 80: 305-311.
  • Ravalico G, Toffoli G, Pastori G, Calderini S. Agerelated ocular blood flow changes. Invest Ophthalmol Vis Sci 1996; 37: 2645-2650.
  • Agarwal HC, Gupta V, Sihota R, Singh K. Pulsatile ocular blood flow among normal subjects and patients with high tension glaucoma. Indian J Ophthalmol 2003; 51: 133-8.
  • Kiekens S, Veva De Groot, Coeckelbergh T, et al. "Continuous positive airway pressure therapy is associated with an increase in intraocular pressure in obstructive sleep apnea. Invest Ophthalmol Vis Sci. 2008; 49: 934-40
  • Kiel JW, Shepherd AP. Autoregulation of choroidal blood flow in the rabbit. Invest Ophthalmol Vis Sci 1992; 33: 2399-2410.
  • Trew DR, Smith SE. Postural studies in pulsatile ocular blood flow: II. Chronic open angle glaucoma. Br J Ophthalmol 1991; 75: 71-75.
  • Spraul CW, Lang GE, Ronzani M, Lang GK. Reproducibility of measurements with a nw slit lamp‐mounted ocular blood flow tonograph. Graefes Arch Clin Exp Ophthalmol 1998; 236: 2742
There are 33 citations in total.

Details

Primary Language English
Journal Section Articles
Authors

Selvi Asker

Ozgur Timucin

Ahmet Ursavas

Mehmet Aslanci This is me

Mehmet Baykara This is me

Haluk Erturk This is me

Muntecep Asker

Sami Yilmaz This is me

Derya Kaya This is me

Publication Date March 14, 2014
Published in Issue Year 2013 Volume: 18 Issue: 4

Cite

APA Asker, S., Timucin, O., Ursavas, A., Aslanci, M., et al. (2014). Obstructive sleep apnea syndrome and blood flow to the eyes. EASTERN JOURNAL OF MEDICINE, 18(4), 165-171.
AMA Asker S, Timucin O, Ursavas A, Aslanci M, Baykara M, Erturk H, Asker M, Yilmaz S, Kaya D. Obstructive sleep apnea syndrome and blood flow to the eyes. EASTERN JOURNAL OF MEDICINE. March 2014;18(4):165-171.
Chicago Asker, Selvi, Ozgur Timucin, Ahmet Ursavas, Mehmet Aslanci, Mehmet Baykara, Haluk Erturk, Muntecep Asker, Sami Yilmaz, and Derya Kaya. “Obstructive Sleep Apnea Syndrome and Blood Flow to the Eyes”. EASTERN JOURNAL OF MEDICINE 18, no. 4 (March 2014): 165-71.
EndNote Asker S, Timucin O, Ursavas A, Aslanci M, Baykara M, Erturk H, Asker M, Yilmaz S, Kaya D (March 1, 2014) Obstructive sleep apnea syndrome and blood flow to the eyes. EASTERN JOURNAL OF MEDICINE 18 4 165–171.
IEEE S. Asker, “Obstructive sleep apnea syndrome and blood flow to the eyes”, EASTERN JOURNAL OF MEDICINE, vol. 18, no. 4, pp. 165–171, 2014.
ISNAD Asker, Selvi et al. “Obstructive Sleep Apnea Syndrome and Blood Flow to the Eyes”. EASTERN JOURNAL OF MEDICINE 18/4 (March 2014), 165-171.
JAMA Asker S, Timucin O, Ursavas A, Aslanci M, Baykara M, Erturk H, Asker M, Yilmaz S, Kaya D. Obstructive sleep apnea syndrome and blood flow to the eyes. EASTERN JOURNAL OF MEDICINE. 2014;18:165–171.
MLA Asker, Selvi et al. “Obstructive Sleep Apnea Syndrome and Blood Flow to the Eyes”. EASTERN JOURNAL OF MEDICINE, vol. 18, no. 4, 2014, pp. 165-71.
Vancouver Asker S, Timucin O, Ursavas A, Aslanci M, Baykara M, Erturk H, Asker M, Yilmaz S, Kaya D. Obstructive sleep apnea syndrome and blood flow to the eyes. EASTERN JOURNAL OF MEDICINE. 2014;18(4):165-71.