Nonarteritic anterior ischaemic optic neuropathy and its association with obstructive sleep apnoea: a health insurance database study

Abstract

There was a strong association between NAION and OSA, and the patients with OSA had a higher risk of NAION. Further large-scale, prospective studies are warranted to evaluate the effect of OSA on developing NAION.

Severe obstructive sleep apnea diagnosed after non-arteritic anterior ischaemic optic neuropathy in a young man

“…A sleep study later on revealed an undiagnosed severe OSA. This case is an example to support the idea of recent literature that OSA is a strong risk factor for NAION 2 3 5 12–14…”

“…Numerous studies have suggested the association between NAION and OSA by evaluating the prevalence of OSA in NAION patients and vice versa 2 3 5 12–14. The prevalence of OSA in NAION patients was reported to be 71% (12 of 17 cases) by Mojon et al 2 and 89% (24 of 27 cases) by Palombi et al 3.…”

“…The mechanism by which OSA is linked to NAION has not been clearly understood, speculated mechanism includes OSA-induced direct hypoxic injury to retinal ganglion cell axons,5 increased intracranial pressure during apneic episodes causing compression at the disc2 and hypoxia-reoxygenation causing oxidative stress, leading to capillary endothelial damage and autoregulatory dysfunction 3. The benefit of CPAP ventilation in NAION has not been established in prospective trials.…”

“…In recent years, the association between obstructive sleep apnea (OSA) and NAION has been increasingly recognised 2 3. NAION in patients under 40 years of age is uncommon4 and it has been suggested that OSA is a strong risk factor particularly in this age group 5. We describe a case of NAION in a 30-year-old man which led to the diagnosis of severe OSA, emphasising the association between OSA and NAION and the need to screen for this condition especially in younger individuals without any additional risk factors.…”

Pathogenese und Therapie der nicht arteriitischen anterioren ischämischen Optikusneuropathie

“…Ein Beginn der atrophen Veränderungen ist bereits nach ca. 4 Risikofaktoren: arterielle Hypertonie, Diabetes mellitus, Hypercholesterinämie, Sehnervendrusen, kleine Papille ("crowded disc") [2,11], Alter [3], Herz-oder Wirbelsäulenchirurgie [12], Schlafapnoe [13,14], Gerinnungsstörungen [15] Art des Zelltods (Verhältnis von Nekrose/Apoptose)…”