BACKGROUND: The prevalence of optic nerve and retinal vascular changes within the obstructive sleep apnea (OSA) population are not well-known, although it has been postulated that optic nerve ischemic changes and findings related to an elevated intracranial pressure may be more common in OSA patients. We prospectively evaluated the ocular fundus in unselected patients undergoing overnight diagnostic polysomnography (PSG). METHODS: Demographic data, medical/ocular history, and nonmydriatic fundus photographs were prospectively collected in patients undergoing PSG at our institution and reviewed for the presence of optic disc edema for which our study was appropriately powered a priori. Retinal vascular changes were also evaluated. OSA was defined using the measures of both sleep-disordered breathing and hypoxia. RESULTS: Of 250 patients evaluated in the sleep center, fundus photographs were performed on 215 patients, among whom 127 patients (59%) had an apnea/hypopnea index (AHI) ≥ 15 events per hour, including 36 with severe OSA. Those with AHI <15 served as the comparison group. None of the patients had optic disc edema (95% confidence interval [CI]: 0%-3%). There was no difference in rates of glaucomatous appearance or pallor of the optic disc among the groups. Retinal arteriolar changes were more common in severe OSA patients (odds ratio: 1.09 per 5 unit increase in AHI; 95% CI, 1.02-1.16; P = 0.01), even after controlling for mean arterial blood pressure. CONCLUSIONS: We did not find an increased prevalence of optic disc edema or other optic neuropathies in our OSA population. However, retinal vascular changes were more common in patients with severe OSA, independent of blood pressure.
BACKGROUND: The prevalence of optic nerve and retinal vascular changes within the obstructive sleep apnea (OSA) population are not well-known, although it has been postulated that optic nerve ischemic changes and findings related to an elevated intracranial pressure may be more common in OSA patients. We prospectively evaluated the ocular fundus in unselected patients undergoing overnight diagnostic polysomnography (PSG). METHODS: Demographic data, medical/ocular history, and nonmydriatic fundus photographs were prospectively collected in patients undergoing PSG at our institution and reviewed for the presence of optic disc edema for which our study was appropriately powered a priori. Retinal vascular changes were also evaluated. OSA was defined using the measures of both sleep-disordered breathing and hypoxia. RESULTS: Of 250 patients evaluated in the sleep center, fundus photographs were performed on 215 patients, among whom 127 patients (59%) had an apnea/hypopnea index (AHI) ≥ 15 events per hour, including 36 with severe OSA. Those with AHI <15 served as the comparison group. None of the patients had optic disc edema (95% confidence interval [CI]: 0%-3%). There was no difference in rates of glaucomatous appearance or pallor of the optic disc among the groups. Retinal arteriolar changes were more common in severe OSA patients (odds ratio: 1.09 per 5 unit increase in AHI; 95% CI, 1.02-1.16; P = 0.01), even after controlling for mean arterial blood pressure. CONCLUSIONS: We did not find an increased prevalence of optic disc edema or other optic neuropathies in our OSA population. However, retinal vascular changes were more common in patients with severe OSA, independent of blood pressure.
Authors: E J Roff; A Harris; H S Chung; S L Hosking; A M Morrison; P J Halter; L Kagemann Journal: Graefes Arch Clin Exp Ophthalmol Date: 1999-12 Impact factor: 3.117
Authors: Y Sugita; S Iijima; Y Teshima; T Shimizu; N Nishimura; T Tsutsumi; H Hayashi; H Kaneda; Y Hishikawa Journal: Electroencephalogr Clin Neurophysiol Date: 1985-03
Authors: Lori L Boland; Eyal Shahar; Tien Y Wong; Ronald Klein; Naresh Punjabi; John A Robbins; Anne B Newman Journal: Sleep Date: 2004-05-01 Impact factor: 5.849
Authors: Brendon Wong; Jessica Y Tong; Angela M Schulz; Stuart L Graham; Claude S Farah; Clare L Fraser Journal: J Clin Sleep Med Date: 2021-05-01 Impact factor: 4.062
Authors: Feng Wang; Elizabeth R Lesser; Jeremy K Cutsforth-Gregory; M Tariq Bhatti; Khin P Kilgore; David O Hodge; Jonathan Graff-Radford; Ronald C Petersen; David S Knopman; Michelle M Mielke; Giuseppe Lanzino; Jaqueline A Leavitt; John J Chen Journal: Front Neurol Date: 2019-08-16 Impact factor: 4.003
Authors: Andreas Yiangou; James L Mitchell; Matthew Nicholls; Yu Jeat Chong; Vivek Vijay; Benjamin R Wakerley; Gareth G Lavery; Abd A Tahrani; Susan P Mollan; Alexandra J Sinclair Journal: J Neurol Date: 2021-08-22 Impact factor: 4.849