TY - JOUR
T1 - Optical coherence tomography angiography and Humphrey visual field in patients with obstructive sleep apnea
AU - Davanian, Arash
AU - Williamson, Lindsay
AU - Taylor, Caitlen
AU - Harrover, Abigail
AU - Bollinger, Kathryn
AU - Chaudhary, Bashir
AU - Taskar, Varsha
AU - Lee, Tae Jin
AU - Liu, Yuhan
AU - Chen, Qingxia
AU - Marcus, Dennis M.
N1 - Publisher Copyright:
Copyright 2022 American Academy of Sleep Medicine. All rights reserved.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Study Objectives: To determine if obstructive sleep apnea syndrome (OSAS) predisposes patients to glaucoma and macular disease due to vascular compromise by evaluating retinal and optic nerve vasculature and function using optical coherence tomography angiography and Humphrey visual field testing, respectively. Methods: In this prospective, observational, cross-sectional study 45 patients undergoing polysomnography ordered per standard of care were selected and stratified based on apnea-hypopnea index (AHI). Medical history, visual acuity testing, 24-2 Humphrey visual field, intraocular pressure measurement, and optical coherence tomography angiography studies of the macular and peripapillary retina were obtained. Correlations between polysomnography parameters and imaging data were analyzed. Results: The radial peripapillary capillary vascular density demonstrated no relationship to AHI (95% confidence interval [CI] [–0.026,0.038]) or severity of OSAS (95% CI: [–0.772, 3.648]) for moderate OSAS compared to mild/normal and (–1.295, 3.1421) for severe compared to mild/normal. Optical coherence tomography angiography superficial parafoveal vascular density (95% CI: [–0.068,0.011], deep parafoveal vascular density (95% CI: [–0.080,0.009]), and foveal avascular zone (95% CI: [–0.001, 0.001]) showed no statistically significant relationship to AHI or OSAS severity after controlling for confounders. Optical coherence tomography retinal nerve fiber layer thickness increased with AHI (P = .014), but there was no statistically significant correlation with OSAS severity with retinal nerve fiber layer thickness (95% CI: [–12.543, 6.792] for moderate comparing to normal and [–2.883, 16.551] for severe comparing to normal). Visual field parameters were unaffected by OSAS (95% CI: mean deviation [–0.21,0.29], pattern standard deviation: [–0.351, 0.121], visual field index: [–0.166, 0.329]). Optical coherence tomography choroidal thickness showed a statistically significant decrease when OSAS was grouped by severity (P = .0092) but did not correlate with AHI (P = .129, 95% CI: [–1.210, 0.095]). Conclusions: The severity of OSAS did not show a statistically significant effect on parameters associated with glaucoma or macular vascular disease. Larger cohorts may be required to determine the physiologic consequences of OSAS on the macular and optic nerve vasculature, structure, and function.
AB - Study Objectives: To determine if obstructive sleep apnea syndrome (OSAS) predisposes patients to glaucoma and macular disease due to vascular compromise by evaluating retinal and optic nerve vasculature and function using optical coherence tomography angiography and Humphrey visual field testing, respectively. Methods: In this prospective, observational, cross-sectional study 45 patients undergoing polysomnography ordered per standard of care were selected and stratified based on apnea-hypopnea index (AHI). Medical history, visual acuity testing, 24-2 Humphrey visual field, intraocular pressure measurement, and optical coherence tomography angiography studies of the macular and peripapillary retina were obtained. Correlations between polysomnography parameters and imaging data were analyzed. Results: The radial peripapillary capillary vascular density demonstrated no relationship to AHI (95% confidence interval [CI] [–0.026,0.038]) or severity of OSAS (95% CI: [–0.772, 3.648]) for moderate OSAS compared to mild/normal and (–1.295, 3.1421) for severe compared to mild/normal. Optical coherence tomography angiography superficial parafoveal vascular density (95% CI: [–0.068,0.011], deep parafoveal vascular density (95% CI: [–0.080,0.009]), and foveal avascular zone (95% CI: [–0.001, 0.001]) showed no statistically significant relationship to AHI or OSAS severity after controlling for confounders. Optical coherence tomography retinal nerve fiber layer thickness increased with AHI (P = .014), but there was no statistically significant correlation with OSAS severity with retinal nerve fiber layer thickness (95% CI: [–12.543, 6.792] for moderate comparing to normal and [–2.883, 16.551] for severe comparing to normal). Visual field parameters were unaffected by OSAS (95% CI: mean deviation [–0.21,0.29], pattern standard deviation: [–0.351, 0.121], visual field index: [–0.166, 0.329]). Optical coherence tomography choroidal thickness showed a statistically significant decrease when OSAS was grouped by severity (P = .0092) but did not correlate with AHI (P = .129, 95% CI: [–1.210, 0.095]). Conclusions: The severity of OSAS did not show a statistically significant effect on parameters associated with glaucoma or macular vascular disease. Larger cohorts may be required to determine the physiologic consequences of OSAS on the macular and optic nerve vasculature, structure, and function.
KW - OCT-A and sleep apnea
KW - glaucoma in sleep apnea
KW - macular degeneration
KW - normal tension glaucoma and sleep apnea
KW - obstructive sleep apnea and vascular dysregulation
KW - optic neuropathy
KW - vascular density in sleep apnea
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U2 - 10.5664/jcsm.10054
DO - 10.5664/jcsm.10054
M3 - Article
C2 - 35532117
AN - SCOPUS:85137136407
SN - 1550-9389
VL - 18
SP - 2133
EP - 2142
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
IS - 9
ER -