Sleep and Breathing

, Volume 17, Issue 2, pp 583–588

Ocular surface assessment in patients with obstructive sleep apnea–hypopnea syndrome

Original Article

DOI: 10.1007/s11325-012-0724-0

Cite this article as:
Acar, M., Firat, H., Acar, U. et al. Sleep Breath (2013) 17: 583. doi:10.1007/s11325-012-0724-0

Abstract

Purpose

The aim of this study was to assess the correlation between ocular surface changes and disease severity in patients with obstructive sleep apnea–hypopnea syndrome (OSAHS).

Methods

Two hundred eighty patients with OSAHS were compared with respect to the presence of a floppy eyelid syndrome (FES), Ocular Surface Disease Index (OSDI) questionnaire, the corneal fluorescein staining stages, the Schirmer I test, and tear film break-up time (TBUT) values.

Results

Based on the apnea–hypopnea index, the presence of FES was detected at the following rates: 23.1 % in non-OSAHS group (A), 41.7 % in mild group (B), 66.7 % in moderate group (C), and 74.6 % in severe group (D); severe and moderate stage of FES was found in groups C and D and mild stage of FES in group B (p < 0.01). OSDI questionnaire values were as follows: group A, 12.57 ± 17.64; group B, 22.90 ± 16.78; group C, 45.94 ± 22.03; and group D, 56.68 ± 22.85(p < 0.01). Schirmer values were as follows: group A, 10.76 ± 3.58 mm; group B, 9.83 ± 2.53 mm; group C, 7.73 ± 2.42 mm; and group D, 6.97 ± 2.15 mm (p < 0.01). The TBUT values were as follows: group A, 10.53 ± 3.64 s; group B, 9.46 ± 2.40 s; group C, 7.29 ± 2.13 s; and group D, 6.82 ± 2.20 s (p < 0.01). Corneal staining scores are as follows: 0.26 ± 0.60 in group A, 0.40 ± 0.71 in group B, 0.98 ± 0.72 in group C, and 1.14 ± 0.90 in group D, and the differences were statistically significant among the groups(p < 0.01).

Discussion

OSAHS, particularly the moderate and severe forms, is associated with low Schirmer and TBUT values and high scores in OSDI questionnaire and corneal staining pattern stage. The presence of FES is observed as a practically constant finding in OSAHS. If complaints such as burning, stinging, and itching which can be commonly observed in middle-aged patients are accompanied by FES, the patient should be evaluated for sleep disorders. We speculate that appropriate treatment of OSAHS may result in better control of these symptoms.

Keywords

Obstructive sleep apneaFloppy eyelid syndromeOcular surface diseaseApnea–hypopnea indexTear function testsOxford scheme

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Mutlu Acar
    • 1
  • Hikmet Firat
    • 2
  • Ugur Acar
    • 1
  • Sadik Ardic
    • 2
  1. 1.Department of Ophthalmology, Ministry of HealthAnkara Diskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey
  2. 2.Department of Chest Medicine and Sleep Disorders Center, Ministry of HealthAnkara Diskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey