Evaluation of the retinal fiber layer thickness as a biomarker for sleep apnea syndrome

Abstract

Purpose To evaluate the peripapillary retinal nerve fiber layer (RNFL) thickness measured with spectral‐domain optical coherence tomography (OCT) in obstructive sleep apnea syndrome (OSA) patients, as a biological marker of neuronal damage. Methods Sixty‐four OSA patients and one hundred twenty‐nine healthy controls were consecutive and prospectively selected. Only one eye per subject was randomly chosen. AOS patients were classified in three groups according to apnea/hipopnea index: mild, moderate and severe. All participants performed a comprehensive ophthalmologic examination and at least a reliable standard automated perimetry (SAP). Peripapillary RNFL thicknesses were measured with the Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). After checking for a normal distribution of variables, differences between both groups were tested by Student t test. Results Age was 50.6 ± 9.3 years in control eyes and 47.8 ± 11.5 years in AOS patients (p = 0.09). Mean deviation of SAP was ‐0.50 ± 1.0 dB and ‐1.4± 2.3 dB, in control and AOS patients, respectively (p<0.001). Pattern standard deviation and Visual Field Index (VFI) of SAP were also different between both groups. The RNFL thickness at temporal superior segment and the superior segment had lower thicknesses in AOS patients compared to healthy individuals. Conclusion OCT detected a mild reduction of RNFL thickness in AOS patients compared with healthy subjects. Visual field indices were also different between both groups.

Walking in the Dark: Lack in the Use of Criminal Statistics for Public Policy and Legislative Actions

“…63 It should also take into consideration the social and economic, legal and institutional implications. 64 The Council of Ministers Working Directive requires that if the bill introduces or modifies criminal sanctions, the Ministry of Justice shall be consulted; and if it has the effect of modifying or creating institutions, the Prime Minister shall be consulted prior to tabling the subject for discussion, and if such bill has financial consequences, the Ministry of Finance and Economic Development shall be consulted and their views form part of the report. 65 The Directive further requires an express assertion that the bill does not contradict constitutional principles, including fundamental rights, and it actually conforms with the existing legal order including international obligations.…”