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Lack of association between obstructive sleep apnea syndrome and specular microscopic features of the corneal endothelium

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of hypoxemia and hypercapnia during sleep. The aim of this study was to determine whether OSAS causes significant changes in corneal endothelium detectable by specular microscopy.

Methods

This prospective, cross-sectional study compared the specular microscopic features of the corneal endothelium of patients with OSAS and age-and gender-matched controls. Patients diagnosed with OSAS by polysomnography in the sleep unit were classified using apnea-hypopnea indexes into two groups as mild-moderate OSAS group and severe OSAS group. All participants were divided into three age groups: 30–45, 46–60, and > 60 years. Corneal endothelial cell density (ECD), percentage of hexagonal cells (Hex), and coefficient of variation of cell area (CV) were obtained using a non-contact specular microscope. The measurements of each group were compared statistically.

Results

A total of 66 patients (51.1 ± 9.4 years) and 88 controls (49.2 ± 10.5 years) were examined. The mild-moderate OSAS group and the severe OSAS group had no significant differences in measures of specular microscopy compared with the controls (ECD, p = 0.84; Hex, p = 0.18; CV, p = 0.41). The mean values of ECD, Hex, and CV were 2552.56 ± 302.49 cells/mm2, 54.13 ± 8.13%, and 36.41 ± 5.92, respectively, in the mild-moderate OSAS group; 2510.52 ± 377.12 cells/mm2, 54.85 ± 8.68%, and 34.77 ± 5.02, respectively, in the severe OSAS group; 2543.37 ± 286.94 cells/mm2, 51.89 ± 9.09%, and 36.03 ± 5.32, respectively, in the control group.

Conclusions

There were no significant differences in corneal endothelial features between patients and controls. Although OSAS causes systemic hypoxia, its effects do not appear to result in corneal endothelial alterations detectable by specular microscopy.

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Authors and Affiliations

  1. Tayfur Ata Sokmen Medical School, Department of Ophthalmology, Hatay Mustafa Kemal University, 31040, Antakya, Hatay, Turkey

    Ayse Idil Cakmak

  2. Tayfur Ata Sokmen Medical School, Department of Chest Diseases, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey

    Nursel Dikmen

  3. Hatay Antakya State Hospital, Ophthalmology Clinics, Antakya, Hatay, Turkey

    Ela Eren

  4. Department of Ophthalmology, Eskişehir Osmangazi University Medical School, Eskişehir, Turkey

    Eray Atalay

Authors
  1. Ayse Idil Cakmak
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  2. Nursel Dikmen
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  3. Ela Eren
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  4. Eray Atalay
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The manuscript has been read and approved by all the authors that the requirements for authorship as stated earlier in this document have been met and that each author believes that the manuscript represents honest work.

Corresponding author

Correspondence to Ayse Idil Cakmak.

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Ethical approval

All procedures performed in the present study involving human participants were in accordance with the ethical standards of the Ethics Committee of Hatay Mustafa Kemal University Tayfur Ata Sokmen Medical School Hospital, Capital Medical University (No. Clinical-Research-Review [2017]144) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical protocol number: 2017/144, Ethic Approval date: October 5th 2017. Decision number: 13.

Conflict of interest

The authors declare that they have no conflict of interest.

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The manuscript was presented as part at the 22nd Annual Congress of the Turkish Thoracic Society with the international participation which was held on 10–14 April 2019 in Antalya, Turkey.

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Cakmak, A.I., Dikmen, N., Eren, E. et al. Lack of association between obstructive sleep apnea syndrome and specular microscopic features of the corneal endothelium. Sleep Breath 25, 843–848 (2021). https://doi.org/10.1007/s11325-020-02222-x

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  • DOI: https://doi.org/10.1007/s11325-020-02222-x

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