Abstract
Purpose
To examine retinal and choroidal thicknesses in individuals with obstructive sleep apnea (OSA) and determine the impacts of continuous positive airway pressure (CPAP) treatment.
Methods
Prospective follow-up study conducted at a university hospital. 40 patients with OSA, 28 treated with CPAP, and 12 untreated, were enrolled immediately after diagnosis and graded according to the apnea hypopnea index (AHI) determined in an overnight polysomnography. Inclusion criteria were a new diagnosis of OSA and CPAP indicated. Participants underwent a full ophthalmologic examination including optical coherence tomography (OCT) at the peripapillary, macular, and choroidal levels and the same examination 3 months later. Outcome measures were peripapillary retinal nerve fiber layer (RNFL), total retinal (TRT), retinal ganglion cell layer (RGCL), inner plexiform layer (IPL), photoreceptor layer (PL), and choroidal thicknesses.
Results
At 3 months, RGCL thickness was reduced at the inner nasal macula segment in the no-CPAP group (P = 0.016). In + CPAP, increases were produced in RNFL thickness (5/6 segments) and TRT (7/ 9 segments), while choroidal thinning was observed temporally (P = 0.003). At baseline, positive correlation was detected between choroidal thickness and AHI (r = 0.352, P = 0.005) and between IPL thickness (7/9 segments) and AHI (r = 0.414, P < 0.001).
Conclusions
Initial retinal and choroidal thickening was followed by RGCL thinning over 3 months. In patients receiving CPAP, we observed no thinning of any retinal layer and normalization of choroidal thickness.
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Abbreviations
- AHI:
-
Apnea hypopnea index
- ART:
-
Automatic real time
- CPAP:
-
Continuous positive airway pressure
- EDI:
-
Enhanced depth imaging
- F:
-
Fovea
- G:
-
Global
- ICC:
-
Intraclass correlation coefficient
- IIM:
-
Inferior inner macula
- IN:
-
Infereronasal
- IOM:
-
Inferior outer macula
- IOP:
-
Intraocular pressure
- IPL:
-
Inner plexiform layer
- IT:
-
Inferotemporal
- N:
-
Nasal
- NIM:
-
Nasal inner macula
- NOM:
-
Nasal outer macula
- OSA:
-
Obstructive sleep apnea
- PL:
-
Photoreceptor layer
- RGCL:
-
Retinal ganglion cell layer
- RNFL:
-
Retinal nerve fiber layer
- SIM:
-
Superior inner macula
- SN:
-
Superonasal
- SOM:
-
Superior outer macula
- SpO2 :
-
Peripheral oxygen saturation
- ST :
-
Superotemporal
- T :
-
Temporal
- TIM :
-
Temporal inner macula
- TOM :
-
Temporal outer macula
- TRT :
-
Total retinal thickness
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All authors contributed to the study, conception, and design. Material preparation, data collection, and analysis were performed by Naranjo-Bonilla P., Muñoz-Villanueva María C., Giménez-Gómez R., and Jurado-Gámez B.. The first draft of the manuscript was written by Naranjo-Bonilla P., Muñoz-Villanueva María C., and Jurado-Gámez B., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Naranjo-Bonilla, P., Muñoz-Villanueva, M.C., Giménez-Gómez, R. et al. Retinal and choroidal thickness measurements in obstructive sleep apnea: impacts of continuous positive airway pressure treatment. Graefes Arch Clin Exp Ophthalmol 259, 3381–3393 (2021). https://doi.org/10.1007/s00417-021-05322-w
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DOI: https://doi.org/10.1007/s00417-021-05322-w