Quantitative evaluation of retinal microvascular circulation in patients with obstructive sleep apnea–hypopnea using optical coherence tomography angiography



To compare capillaries perfusion in macular areas at different layers and peripapillary region in radial peripapillary capillaries (RPC) between healthy subjects and subjects with obstructive sleep apnea–hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA).


Totally 16 eyes with mild-to-moderate OSA, 14 eyes with severe OSA and 22 control eyes were enrolled in this study. Every subject filled out the Berlin questionnaire and received a comprehensive ocular and physical examination. The clinical characteristics were collected, OCT and OCTA scans using OCTA RT XR Avanti (AngioVue software, Optovue Inc., Fremont, CA, USA) were performed and analyzed.


Compared to the control group, the severe group had significantly higher VD in parafovea and perifoveal regions (p = 0.031; p = 0.029) at the level of deep capillary plexus (DCP), whereas the mild-to-moderate group had a significantly lower VD in the peripapillary region on RPC network in disc areas (p = 0.013).


Blood flow changes in macular areas might first appear at the DCP layer in OSA patients. Reduced VD in the peripapillary region at the RPC layer might be associated with OSA and cause subsequent RNFL changes.

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The authors are grateful to all the patients who participated in this study.


This study was supported by the National Natural Science Foundation of China (Grant No. 81970815).

Author information




XS and FH designed this study. XS, GSS, and YC defined the criteria for inclusion and exclusion. LZ, GSS, and YC performed examinations. LZ and YC analyzed and interpreted the patient data. YC drafted this manuscript and made the figures and tables. XS, FH, and MWZ modified the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xuan Shi.

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The authors declare that there are no conflicts of interest regarding the publication of this paper.

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The data supporting this study are available upon request from Prof. Xuan Shi (e-mail: drxuanshi@163.com).

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This study adhered to the tenets of the Declaration of Helsinki and was approved by the Ethics Committee of People’s Hospital of Peking University. Informed consent was obtained from all individual participants included in the study.

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Cai, Y., Sun, G., Zhao, L. et al. Quantitative evaluation of retinal microvascular circulation in patients with obstructive sleep apnea–hypopnea using optical coherence tomography angiography. Int Ophthalmol (2020). https://doi.org/10.1007/s10792-020-01518-x

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  • Deep capillary plexus
  • Optical coherence tomography angiography
  • Obstructive sleep apnea–hypopnea
  • Retinal nerve fiber layer
  • Radial peripapillary capillary
  • Vessel density