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Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To compare parameters for retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) measurements, and macular thickness in patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) versus normal controls.

Methods

Patients presenting with snoring and daytime sleepiness who underwent overnight polysomnography to determine OSAHS severity were recruited, and subsequently referred for ophthalmologic evaluation. Optical coherence tomography was used to evaluate the retinal nerve fiber layer (RNFL), optic nerve head topography, and macular thickness for early detection of glaucoma. Patients determined not to have OSAHS were included as controls.

Results

A total of 127 subjects were recruited, including 105 patients with OSAHS and 22 normal control subjects. RNFL thickness was significantly lower for the severe OSAHS group than for the control and mild OSAHS groups in the average (p < 0.0001) and in the superior quadrant (p = 0.0007). When subjects without OSAHS or with mild disease (AHI < 15) were grouped together and compared with patients with moderate/severe OSAHS (AHI ≧ 15), RNFL thickness measurements for the latter group were significantly lower in the average (p < 0.0001), and in the superior (p = 0.001), inferior (p = 0.029), and temporal (p = 0.007) quadrants. Positive correlations were identified between lowest oxygenation saturation on PSG and RNFL thickness in the average (r = 0.260), superior (r = 0.200) and nasal (r = 0.156) quadrants.

Conclusions

Compared to patients without OSAHS or those with mild disease, RNFL thickness was lower in patients with moderate/severe OSAHS. Lowest saturation of oxygen in the moderate/severe OSAHS group correlated with decreased RNFL thickness. Patients with moderate and severe OSAHS are at increased risk for glaucoma.

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Acknowledgements

This study was supported by grants CMRPG880051 awarded by the Chang Gung Memorial Hospital, Taiwan. The authors thank Drs Mao-Chang Su, Yung-Che Chen and Meng-Chih Lin for help in manuscript preparation.

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Authors and Affiliations

  1. Department of Ophthalmology, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Pei-Wen Lin

  2. Department of Otolaryngology and Bronchoesophagology, Division of Sleep Surgery, Rush University Medical Center, Chicago, IL, USA

    Michael Friedman

  3. Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA

    Michael Friedman & Tanya M. Pulver

  4. Department of Otolaryngology, Sleep Center, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hsin-Ching Lin

  5. Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Hsueh-Wen Chang

  6. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Sleep Center, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Chien-Hung Chin

  7. Department of Otolaryngology, Sleep Center, Chang Gung Memorial Hospital–Kaohsiung Medical Center, 123, Ta-Pei Rd., Niao-Sung Hsiang, Kaohsiung Hsien, 833, Taiwan

    Hsin-Ching Lin

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  1. Pei-Wen Lin
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  2. Michael Friedman
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Correspondence to Hsin-Ching Lin.

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Ethics committee approval was obtained from the institutional review board and ethics committee at Chang Gung Memorial Hospital. Taiwan.

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Lin, PW., Friedman, M., Lin, HC. et al. Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome. Graefes Arch Clin Exp Ophthalmol 249, 585–593 (2011). https://doi.org/10.1007/s00417-010-1544-1

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  • DOI: https://doi.org/10.1007/s00417-010-1544-1

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