Visual field defects and retinal nerve fiber imaging in patients with obstructive sleep apnea syndrome and in healthy controls

Abstract

BackgroundTo assess the retinal sensitivity in obstructive sleep apnea hypopnea syndrome (OSAHS) patients evaluated with standard automated perimetry (SAP). And to correlate the functional SAP results with structural parameters obtained with optical coherence tomography (OCT).MethodsThis prospective, observational, case-control study consisted of 63 eyes of 63 OSAHS patients (mean age 51.7 ± 12.7 years, best corrected visual acuity ≥20/25, refractive error less than three spherical or two cylindrical diopters, and intraocular pressure < 21 mmHg) who were enrolled and compared with 38 eyes of 38 age-matched controls. Peripapillary retinal nerve fiber layer (RNFL) thickness was measured by Stratus OCT and SAP sensitivities and indices were explored with Humphrey Field Analyzer perimeter. Correlations between functional and structural parameters were calculated, as well as the relationship between ophthalmologic and systemic indices in OSAHS patients.ResultsOSAHS patients showed a significant reduction of the sensitivity for superior visual field division (p = 0.034, t-student test). When dividing the OSAHS group in accordance with the severity of the disease, nasal peripapillary RNFL thickness was significantly lower in severe OSAHS than that in controls and mild-moderate cases (p = 0.031 and p = 0.016 respectively, Mann-Whitney U test). There were no differences between groups for SAP parameters.We found no correlation between structural and functional variables. The central visual field sensitivity of the SAP revealed a poor Pearson correlation with the apnea-hipopnea index (0.284, p = 0.024).ConclusionsRetinal sensitivity show minor differences between healthy subjects and OSAHS. Functional deterioration in OSAHS patients is not easy to demonstrate with visual field examination.

Comparison of retinal nerve fiber layer thickness between normal population and patients with diabetes mellitus using optical coherence tomography

“…Assessment of Retinal Nerve Fiber Layer (RNFL) thickness has been in clinical practice for early detection of glaucoma 3. Since glaucoma is a form of optic neuropathy, researchers have found variation in RNFL thickness in patients suffering from various neuropathies like migraine, Alzheimer’s disease, multiple sclerosis, obstructive sleep apnea and neurofibromatosis 4-8…”

Retinal Nerve Fiber Layer Thickness in Patients With Obstructive Sleep Apnea

“…Kargi et al, 8 and Sun et al 28 found that RNFLT in superior and inferior quadrants was more sensitive than in other quadrants in OSA disease by subgroup analysis. But, Shiba et al, 5 Kisabay et al, 26 and Casas et al 29 showed a significant difference in RNFLT only in nasal quadrants between OSA subgroups. Our findings were in contrast to the findings of Ferrandez et al, 21 Guven et al, 23 and Adam et al, 24 who found no differences in RNFLT in any of the 4 quadrants between the OSA subgroups.…”

Differential effects of obstructive sleep apnea on the corneal subbasal nerve plexus and retinal nerve fiber layer

“…Our first key finding was the presence of RNFL thinning in the optic nerve/peripapillary region in participants with OSA. RNFL thinning has been previously reported in patients with OSA, along with decreased visual evoked potentials [ 9 , 10 , 31 – 47 , 56 ]. Importantly, while RNFL thinning has been reported in myopic eyes and associated with health conditions including migraines, diabetes, multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease, this usually results in more diffuse thinning [ 57 – 62 ].…”