Assessment of the Effectiveness of Obstructive Sleep Apnea Treatment Using Optical Coherence Tomography to Evaluate Retinal Findings

Abstract

Retinal findings may change in patients with obstructive sleep apnea syndrome (OSAS). The present study aims to evaluate several retinal findings, such as macula layer thickness, the peripapillary retinal nerve fiber layer, and the optic nerve head in patients with OSAS, using optical coherence tomography (OCT); it also aims to monitor the result of several types of treatment of OSAS with OCT. A prospective comparative study was designed. Patients were recruited at a Sleep Unit of a University Hospital and underwent comprehensive ophthalmological examinations. Following exclusion criteria, fifty-two patients with OSAS were finally included. Patients were examined by OCT twice: once before treatment, and again after six months of treatment. In mild–moderate patients, where retinal swelling had been demonstrated, retinal thicknesses decreased [fovea (p = 0.026), as did inner ring macula (p = 0.007), outer ring macula (p = 0.015), and macular volume (p = 0.015)]. In severe patients, where retinal atrophy had been observed, retinal thickness increased [fovea (p < 0.001)]. No statistically significant differences in efficacy between treatments were demonstrated. In conclusion, OCT can evaluate the retina in patients with OSAS and help to monitor results after treatment. In severe OSAS, retinal thickness increased six months after treatment.

Peripheral retinal neovascularization in a patient with obstructive sleep apnea

“… 10 Additionally, a recent study found that patients who underwent treatment of OSA were found to have normalization of OCT abnormalities, presumably due to correction of their nocturnal hypoxemia. 11 Patients with peripheral nonperfusion and neovascularization should receive targeted retinal photocoagulation and/or vascular endothelial growth factor antagonist intravitreal therapy which is the mainstay of treatment of proliferative retinopathy. Heightened awareness of the potential role of OSA to cause retinal hypoxia may suggest a greater need for OSA screening in patients, especially diabetics, with peripheral retinal neovascularization, as treatment with CPAP may reduce retinal hypoxic burden.…”