Reduced Retinal Vessel Density in Obstructive Sleep Apnea Syndrome Patients: An Optical Coherence Tomography Angiography Study
Reduced Retinal Vessel Density in Obstructive Sleep Apnea Syndrome Patients: An Optical Coherence Tomography Angiography Study
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DOI：
10.1167/iovs.17-21414
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发表时间：
2017-07-01
影响因子：
4.4
通讯作者：
Jiang, Chunhui
中科院分区：
文献类型：
--
作者：
Yu, Jian;Xiao, Kuanlin;Jiang, Chunhui
目的.目的：研究阻塞性睡眠呼吸暂停低通气综合征（OSAS）患者的视网膜血管，并探讨视网膜血管与OSAS严重程度的相关性。前瞻性、横断面研究。入组了69例接受多导睡眠描记术的连续受试者。患者根据OSAS的严重程度分为三组，使用呼吸暂停低通气指数（AHI）定义为正常至轻度（AHI < 15），中度（< 15至< 30），或重度（>= 30）。比较3组间血管密度、黄斑区及视网膜神经纤维层厚度。还确定了临床变量（年龄、心率、体重指数、眼灌注压、等效球镜、IOP、视网膜内层厚度和AHI）与血管密度之间的相关性。三组的全层和内层视网膜旁厚度以及视网膜神经纤维层厚度相似。视网膜血管密度随OSAS严重程度增加而降低。视乳头周围和视乳头旁区域的血管密度降低不同。中度组视乳头周围区血管密度明显低于正常-轻度组（P < 0.05），而视乳头旁区血管密度与正常-轻度组相似（P > 0.05）。视乳头周围区和视乳头旁区的血管密度与AHI呈显著负相关（均P <0. 05），视乳头旁区血管密度的相对降低程度大于视乳头旁区。在OSAS患者中，视乳头周围区和视乳头旁区的血管密度随着疾病严重程度的增加而降低，并且视乳头周围区的降低更为显著。
PURPOSE. To examine the retinal vasculature in patients with obstructive sleep apneahypopnea syndrome ( OSAS) and to determine the correlation between retinal vascularity and the severity of OSAS.DESIGN. Prospective, cross-sectional study.METHODS. Sixty-nine consecutive subjects who underwent polysomnography were enrolled. Patients were divided into three groups according to the severity of OSAS, which was defined using the apnea-hypopnea index (AHI) as normal-to-mild (AHI < 15), moderate (< 15 to < 30), or severe (>= 30). The vessel densities, and macular and retinal nerve fiber layer thicknesses were compared among the three groups. The correlations between clinical variables (age, heart rate, body mass index, ocular perfusion pressure, spherical equivalence, IOP, inner retinal thickness, and AHI) and vessel densities were also determined.RESULTS. The full and inner parafoveal retinal thickness and the retinal nerve fiber layer thickness were similar in all three groups. The retinal vessel density decreased with greater severity of OSAS. The decrease in vessel density differed between the peripapillary and parafoveal areas. The moderate group had a significantly lower vessel density than the normalto- mild group in the peripapillary area (P < 0.05), but similar vessel density as the normal-tomild group in the parafoveal area (P > 0.05). The vessel densities in the parafoveal and peripapillary areas were significantly and negatively correlated with AHI (both P < 0.05); the relative reduction in vessel density was greater in the peripapillary area than in the parafoveal area.CONCLUSIONS. In OSAS patients, the vessel densities in the peripapillary and parafoveal areas decreased with greater disease severity, and the decrease was more prominent in the peripapillary area.