A Steindel1, C Lautenschläger, H G Struck. 1. Augenarztpraxis Aschersleben, Dres. Steindel & Steindel Partnerschaft, Taubenstrasse 14, Aschersleben, Deutschland. praxis@steindel.de
Abstract
PURPOSE: A prospective controlled cohort study examined the effects of obstructive sleep apnea syndrome (OSAS) on the visual field, including morphological and physiological aspects. METHODS: Thirty-two patients with newly discovered and previously untreated moderate to severe OSAS (apnea-hypopnea index >20) were compared with a control group of 32 healthy individuals. Global visual field indices [mean deviation (MD), corrected pattern standard deviation (CPSD)] were compared, and optic disc changes, intraocular pressure, correlations between MD and polysomnography, and the frequency of local defects (using the Humphrey Field Analyzer) were examined. RESULTS: The MD was significantly reduced (R -1.66/L -1.62 dB; p<0.001) in OSAS patients, whereas there was no difference in CPSD. Diffuse local defects in the middle periphery of the 30° visual field were increased in OSAS patients (p<0.003). Normal intraocular tension values were found in all persons, with no correlation to MD. The incidence of pathological optic disc changes was increased in the apnea group (6.25%). CONCLUSIONS: OSAS seems to lead to reduced sensitivity in the visual field by diffuse rarefaction of nerve tissue in the retina, optic nerve, or both. An increased incidence of development of a low-tension glaucoma is assumed.
PURPOSE: A prospective controlled cohort study examined the effects of obstructive sleep apnea syndrome (OSAS) on the visual field, including morphological and physiological aspects. METHODS: Thirty-two patients with newly discovered and previously untreated moderate to severe OSAS (apnea-hypopnea index >20) were compared with a control group of 32 healthy individuals. Global visual field indices [mean deviation (MD), corrected pattern standard deviation (CPSD)] were compared, and optic disc changes, intraocular pressure, correlations between MD and polysomnography, and the frequency of local defects (using the Humphrey Field Analyzer) were examined. RESULTS: The MD was significantly reduced (R -1.66/L -1.62 dB; p<0.001) in OSAS patients, whereas there was no difference in CPSD. Diffuse local defects in the middle periphery of the 30° visual field were increased in OSAS patients (p<0.003). Normal intraocular tension values were found in all persons, with no correlation to MD. The incidence of pathological optic disc changes was increased in the apnea group (6.25%). CONCLUSIONS: OSAS seems to lead to reduced sensitivity in the visual field by diffuse rarefaction of nerve tissue in the retina, optic nerve, or both. An increased incidence of development of a low-tension glaucoma is assumed.