Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome

Abstract

Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by transient upper airway resistance caused by a recurrent reduction or cessation of airflow, due to partial or complete occlusion of the upper airway during sleep. It is associated with sleep fragmentation, arousals, bradycardia, tachycardia, and inadequate oxygen saturation despite an increased respiratory effort (1) . Major clinical consequences of the disorder include excessive daytime sleepiness, neurocognitive dysfunction, cardiovascular diseases (hypertension, ABSTRACTPurpose: To compare the subfoveal choroidal thickness (SFCT) of patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) and normal controls via enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this retrospective, case-control study, 49 eyes from 49 patients that had undergone polysomnography were included. SFCT of the horizontal and vertical line scans were manually measured for all eyes based on EDI-OCT images. Two separate analyses were performed according to different apnea/hypopnea index (AHI) groupings. Initial testing was conducted using non-OSAHS, mild OSAHS (5≤AHI<15), moderate OSAHS (15≤AHI<30), and severe OSAHS (AHI≥30) patient groupings, while secondary testing used non-OSAHS, mild OSAHS (5≤AHI<15), and moderate/severe OSAHS (AHI≥15) patient groupings. Results: The mean SFCT was 314.5 µm in the non-OSAHS patients (n=14), 324.5 µm in the mild OSAHS patients (n=15), 269.3 µm in the moderate OSAHS patients (n=11), and 264.3 µm in the severe OSAHS patients (n=9). SFCT between the four groups revealed no significant differences despite a trend towards slight thinning in the severe group (P=0.08). When the moderate and severe groups were merged and compared with the mild OASHS and non-OSAHS groups, SFCT of the moderate/severe group was found to be significantly thinner than that of the mild group (P=0.016). A negative significant correlation was found between SFCT and AHI in OSAHS patients (r=0.368, P=0.033). Conclusions:In patients with moderate/severe OSAHS, EDI-OCT revealed a thinned SFCT. Other accompanying systemic or ocular diseases may induce perfusion and oxygenation deficiency in eyes of OSAHS patients. Further studies are required in order to determine the exact relationships between ocular pathologies and clinical grades of OSAHS. Keywords

Choroidal thickness evaluation in paediatric patients with adenotonsillar hypertrophy

“…Using enhanced-depth imaging optical coherence tomography, Kara et al . demonstrated that subfoveal choroidal thickness was decreased in patients with moderate or severe OSAS 13 . Karalezli et al .…”

The Effect of Obstructive Sleep Apnea Treatment and Severity on Choroidal Thickness in Patients With Central Serous Chorioretinopathy

“…From a pathophysiologic standpoint, CSC and OSA are known to have opposing effects on CT, with CSC being associated with increased CT and OSA being associated with decreased CT. 10 -14 Prior studies have investigated CT in patients with CSC or OSA but have not addressed OSA treatment status and OSA severity as measured by overnight in-laboratory polysomnography, nor have important variables such as Oxygen Desaturation Index (ODI) or nocturnal oxygen saturation (SpO 2 ) nadir been evaluated. 15 -17 The ODI is a measure of hypoxemic burden during sleep secondary to OSA, and is defined as a 3% or more change in the number of oxygen desaturation events per hour of sleep (eg, a drop in nocturnal SpO 2 nadir from 99% to 95% would be considered an oxygen desaturation event). The use of these novel biometric features allows for a detailed characterization of OSA disease severity not previously leveraged in the ophthalmology literature but often described in the sleep medicine literature.…”

Evaluation of choroidal thickness measurements in patients with marked nasal septal deviation

“…Many studies in the literature have investigated the effect of Obstructive Sleep Apnea Syndrome (OSAS) on CT. 7 , 8 , 9 , 10 , 11 In a meta-analysis evaluating these studies, a decline in choroid thickness was found in the CT of patients with Obstructive Sleep Apnea (OSA). 12 It was argued that the enhancing effect of recurrent upper respiratory tract obstructions during sleep on sympathetic activity, hypoxia and hypercapnia resulted from deterioration of vascular circulation and choroidal blood flow.…”

“…Chronic hypoxia and hypercapnia due to NSD may affect the choroidal blood flow and may change the choroidal thickness. Although several studies have investigated CT in patients with OSAS, 7 , 8 , 9 , 10 , 11 to best of our knowledge there is no study investigating CT in patients with NSD. Therefore, in the present study, we aimed to evaluate the CT using EDI-OCT in MNSD patients.…”