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

Abstract

Objective:To investigate the changes of retinal nerve fiber layer (RNFL) thickness in obstructive sleep apnea syndrome (OSAS) patients.Methods:Relevant studies were selected from 3 major literature databases (PubMed, Cochrane Library, and EMBASE) without language restriction. Main inclusion criteria is that a case-control study in which RNFL thickness was measured by a commercial available optical coherence tomography (OCT) in OSAS patients. Meta-analysis was performed using STATA 12.0 software. Efficacy estimates were evaluated by weighted mean difference with corresponding 95% confidence intervals (CIs). Primary outcome evaluations were: the average changes of RNFL thickness in total OSAS patients, subgroup analysis of RNFL thickness changes in patients of different OSAS stages, and subgroup analysis of 4-quadrant RNFL thickness changes in total OSAS patients.Results:Of the initial 327 literatures, 8 case-control studies with 763 eyes of OSA patients and 474 eyes of healthy controls were included (NOS scores ≥6). For the people of total OSAS, there had an average 2.92 μm decreased RNFL thickness compared with controls (95% CI: −4.61 to −1.24, P = 0.001). For subgroup analysis of OSAS in different stages, the average changes of RNFL thickness in mild, moderate, severe, and moderate to severe OSAS were 2.05 (95% CI: −4.40 to 0.30, P = 0.088), 2.32 (95% CI: −5.04 to 0.40, P = 0.094), 4.21 (95% CI: −8.36 to −0.06, P = 0.047), and 4.02 (95% CI: −7.65 to −0.40, P = 0.03), respectively. For subgroup analysis of 4-quadrant, the average changes of RNFL thickness in Superior, Nasal, Inferior, and Temporal quadrant were 2.43 (95% CI: −4.28 to −0.57, P = 0.01), 1.41 (95% CI: −3.33 to 0.51, P = 0.151), 3.75 (95% CI: −6.92 to −0.59, P = 0.02), and 0.98 (95% CI: −2.49 to 0.53, P = 0.203), respectively.Conclusion:Our study suggests that RNFL thickness in OSAS patients is much thinner than healthy population, especially in superior and inferior quadrant. The impact of OSAS disease on RNFL and visual function should be taken seriously in the further study.

Correlation between structural progression in glaucoma and obstructive sleep apnea

“…Several similar studies regarding RNFL thickness and OSA severity were later conducted, and a meta-analysis by Yu et al [37] showed that both moderate and severe OSA were associated with a significant decrease in average, superior, inferior, and nasal RNFL thickness on OCT [37]. Other meta-analysis studies have also provided similar results [38][39][40][41]. More recently, Liguori et al [30] demonstrated that patients with severe OSA exhibited a significantly more delayed latency and significantly lower amplitude of P100 waves on their visual evoked potential than the controls; however, electroretinography results did not differ significantly between the patients with OSA and controls [30].…”

Contributions of the Melanopsin-Expressing Ganglion Cells, Cones, and Rods to the Pupillary Light Response in Obstructive Sleep Apnea

“…79 Previous papers have reported a strong link between OSA and optic nerve disorders. 7,[19][20][21][80][81][82][83][84] Studies of electrophysiology and RNFL thickness have reported conflicting findings in OSA patients, some showed significant reduction of the RNFL thickness, 9,19,21,71 pattern electroretinogram (PERG), 82,84 and visual evoked potential (VEP), 83,84 while others found no decrease [85][86][87] or alterations of ERG. 83 Our results did not show any reduction of RNFL thickness or VF in the OSA group, in agreement with previous studies by Salzgeber et al, 87 Ferrandez et al, 85,86 and Yu et al, 88 which did not find significant thinning of the RGC layer or macular thickness in OSA patients.…”

Clinicopathological and prognostic significance of homeobox transcript antisense RNA expression in various cancers

“…[ 27 ] Studies with more than 6 stars were considered to be high quality studies. [ 28 , 29 ] Two authors performed the assessment independently and any disagreement was resolved by discussion.…”