Self-Reported Sleep Duration in Patients with Neovascular Age-Related Macular Degeneration

Purpose: To examine the relationship between self-reported sleep duration and neovascular age-related macular degeneration (nAMD).

Methods: This case-control study comprised 165 subjects (57 patients with nAMD and 108 controls). Controls were matched to cases by age and sex. Participants completed a questionnaire that included questions about sleep duration and quality. Four categories of sleep duration were established; <6 hours, 6–7 hours, 7–8 hours and >8 hours. Association of sleep duration and nAMD was assessed by logistic regression analysis. Multiple logistic regression models were performed to control for possible confounders.

Results: We found a significant association between short sleep duration and nAMD (for <6 hours, odds ratio, OR, 3.29, 95% confidence interval, CI, 1.32–8.27; for 6–7 hours, OR 2.25, 95% CI 0.80–6.32; and for >8 hours, OR 1.39, 95% CI 0.53–3.73) compared with the reference category of 7–8 hours. This association remained significant after adjustment for confounders (<6 hours, OR 3.09, 95% CI 1.20–7.97). In addition, a borderline significant association was observed between self-reported very bad sleep quality and nAMD (OR 2.84, 95% CI 1.02–7.88). The highest rate of sleep medication use was found in the nAMD group (p < 0.001).

Conclusion: Our findings provide evidence to support an association between short sleep duration and nAMD. Considering strategies to improve sleep in these patients may prevent the negative effects of sleep deficiency.     

睑板腺功能障碍与睡眠质量的相关性研究

目的:研究睑板腺功能障碍(MGD)与睡眠质量之间的相关性。方法:回顾性病例对照研究。选取2021-01/2022-10我院收治的MGD患者150例,根据匹兹堡睡眠质量指数(PSQI)量表评分分为睡眠障碍组(75例,PSQI>10分)和对照组(75例,PSQI≤10分),均进行眼表疾病指数量表(OSDI)评分和睑板腺相关检查(睑缘形态、睑板腺分泌能力、睑板腺分泌物性质评分)、角膜荧光素染色(FL)评分、基础泪液分泌试验(SⅠt),检测泪膜破裂时间(BUT),评估睡眠指标(睡眠质量、睡眠潜伏期、主观睡眠质量、睡眠时间)。结果:两组患者OSDI评分、FL评分、SⅠt、BUT、睑缘形态评分、睑板腺分泌能力评分、睑板腺分泌物性质评分均有差异(P<0.05)。睡眠障碍组患者PSQI评分、睡眠潜伏期评分、主观睡眠质量评分、睡眠时间评分与OSDI评分、FL评分、睑板腺分泌能力评分和睑板腺分泌物性质评分均呈显著正相关性(P<0.05);PSQI评分、主观睡眠质量评分、睡眠时间评分与睑缘形态评分均呈显著正相关性(P<0.05);PSQI评分、睡眠潜伏期评分、主观睡眠质量评分与BUT...     

The eye and sleep

BACKGROUND: Sleep-associated disorders of the eye are increasingly recognized. Disordered sleep has also been found in some blind patients. METHODS: Review of the current state of knowledge of sleep-related eye disorders and blindness-related sleep disorders. RESULTS: Incomplete eyelid closure during sleep (lagophthalmos) may be physiological but in some patients can cause significant symptoms. Nocturnal lagophthalmos may be a limiting factor in the surgical repair of some eyelid and orbital disorders. Normal eyelid closure has also been linked to the development of a number of ocular surface disorders. Sleep disorders are common, and obstructive sleep apnoea (OSA) the commonest. OSA is associated with a number of serious systemic diseases and also several eye disorders including floppy eyelid syndrome, optic neuropathy, glaucoma, anterior ischaemic optic neuropathy and papilloedema secondary to raised intracranial pressure. Treatment of OSA may help floppy eyelid syndrome, halt progression of associated glaucoma, and reduce intracranial pressure in patients with associated papilloedema. The diagnosis of OSA can only be made with formal sleep studies, but asking a small number of appropriate questions will help screen those patients who should be referred for sleep studies. Some blind patients have disordered sleep patterns due to disruption of the retinal input into the hypothalamic-pineal melatonin secreting apparatus. This can be alleviated by oral administration of melatonin. CONCLUSIONS: Ophthalmologists should be aware of sleep-associated eye disorders and refer appropriate patients for formal sleep studies. Sleep abnormalities in blind patients should be enquired about and patients offered assessment and treatment by a sleep physician.     

睡眠行为与近视发生发展关系研究进展

近视已成为全球范围的公共卫生问题.睡眠是在褪黑素调节下,人类生命过程中重要的周期性生理过程.睡眠与近视一样都会受到环境因素的影响,不同近视程度患者及正视人群在睡眠时间、睡眠质量及褪黑素水平上存在差异.本文回顾了近视发生发展与人群睡眠行为的现状研究及相关的基础实验学研究,从流行病学和生物学机制两方面,对近视发生发展与睡眠...     

中心性浆液性脉络膜视网膜病变患者睡眠质量分析

 目的 分析中心性浆液性脉络膜视网膜病变（CSC）患者睡眠质量状况。设计 问卷调查。研究对象 中心性浆液性脉络膜视网膜病变患者21例,健康对照者21例。 方法 应用匹兹堡睡眠质量指数问卷（Pittsburgh Sleep Quality Index,PSQI）评估CSC患者和正常对照组的睡眠质量状况,受试者独立自我评定。主要指标 PSQI各因子评分及总分。结果 CSC组PSQI总均分为8.76±5.07,与正常对照组（3.57±1.72）相比差异有统计学意义（P=0.000）;睡眠质量评分1.67±0.86,入睡时间评分1.33±1.32,日间功能评分2.24±0.10,睡眠效率评分0.86±1.15,睡眠障碍评分1.38±0.67,与对照组（分别为：0.71±0.64、0.24±0.44、0.90±0.54、0.19±0.40、0.95±0.22）相比差异均有统计学意义（P均<0. 05）。结论 不同程度的睡眠障碍可能是CSC患者的发病因素之一。（眼科, 2013, 22: 124-126）     

青光眼与睡眠

睡眠对于每个人来说都是非常重要的,对于青光眼患者更有极其特殊的意义。睡眠质量对青光眼有很大影响,而青光眼的躯体症状和患者的心理因素又对睡眠产生较大的影响。夜间睡眠时眼压会升高,而眼压是影响青光眼病情最重要的因素,夜间眼压波动对视功能有很大的损害。睡眠期间是青光眼治疗的关键时段,应引起青光眼患者和医生的足够重视。     

IOP elevation in different phases of sleep

Large and significant increases in intraocular pressure (IOP) have previously been demonstrated after as little as 30 minutes of sleep.¹² The present experiment tests the hypothesis that the lack of eye movements during sleep is responsible for this increase in IOP. Nine subjects slept in the laboratory on two separate nights. IOP was measured (with subjects in the supine position) using a Keeler Pulsair noncontact tonometer. Eye movements were monitored using electro-oculography. Subjects were woken from sleep after 60–90 minutes, on one night when they were in rapid eye movement (REM) sleep, and on one night when they were not. IOP increased significantly on both nights, but the differences between these increases was not significant. Thus, mechanical factors associated with lack of eye movements do not appear to contribute to the increase in IOP after sleep.     

夜戴型角膜塑形镜对近视患者睡眠质量的影响

目的：观察配戴夜戴型角膜塑形镜对近视患者睡眠质量的影响。

方法：选取就诊于福建中医药大学附属人民医院眼科配戴夜戴型角膜塑形镜的近视患者30例58眼为试验组,随机选取同期配戴框架眼镜的近视患者30例60眼作为对照组。所有患者分别于戴镜前和戴镜后1、3mo应用匹茨堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)进行睡眠质量评估, 观察比较两组患者的睡眠质量。

结果：试验组患者戴镜前、戴镜后1、3mo等效球镜度数分别为-2.78±0.90、-0.30±0.31、-0.28±0.30D,戴镜后1、3mo分别与戴镜前比较,差异均有统计学意义(P<0.05)。戴镜前、戴镜后1、3mo试验组PSQI评分分别是2.13±1.36、2.47±1.98、1.74±1.39分。试验组与对照组比较,戴镜后3mo主观睡眠质量评分的差异具有统计学意义(P<0.05),而PSQI评分和入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能的评分差异均无统计学意义(P>0.05)。

结论：配戴夜戴型角膜塑形镜对近视患者总体睡眠质量无明显影响,在配戴初期患者主观睡眠质量下降。     

A 5-year analysis of endothelial vs penetrating keratoplasty graft survival in Chinese patients

AIM: To determine if there is any difference in long term graft survival between Descemet’s stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty (PK). METHODS: A retrospective 5-year cases analysis of bullous keratopathy secondary to Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy, receiving either DSEK or PK. A total of 42 DSEK cases and 25 PK cases were included in the analysis. RESULTS: In the 5-year analysis, graft survival rates were very similar in the two groups (DSEK 77.1% vs PK 76.0%, P=0.918, 95%CI: -6.3 to 33.4). Sub-analyses at 1y (DSEK 81% vs PK 95%, P=0.085, 95%CI: -29 to 3.6) and 2y (DSEK 81% vs PK 88%, P=0.381, 95%CI: -25.9 to 11.8) show a trend towards lower survival rates of DSEK vs PK, but the results were not statistically significant. CONCLUSION: Long term 5-year graft survival is similar between the DSEK and PK methods of corneal transplant in Chinese patients with bullous keratopathy.     

阻塞性睡眠呼吸暂停低通气综合征200例的围手术期处理

目的 探讨围产手术期处理对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）诊断、治疗及预后的价值。方法 对200例OSAHS患者的术前、术中及术后进行精心准备和完善的监护、诊断与治疗。结果 本组病例，临床治愈157例，好转43例，出现术后出血4例，经止血对症治疗后好转；出现腭咽关闭不全25例，其中23例1周后随着术后反应性水肿消退而恢复，2例6个月后仍存在腭咽关闭不全及开放性鼻音。结论 围手术期处理极大地提高了OSAHS患者手术治愈率，最大限度降低了手术并发症出现。     

阻塞性睡眠呼吸暂停综合征与青光眼的关系

阻塞性睡眠呼吸暂停综合征（ｏｂｓｔｒｕｃｔｉｖｅｓｌｅｅｐａｐｎｅａｓｙｎｄｒｏｍｅ,ＯＳＡＳ）是涉及全身多器官的呼吸系统的常见病。近年来大量的研究显示,ＯＳＡＳ与青光眼之间有着密切关系。本文从发病率、客观检查、发病机制等方面对ＯＳＡＳ与青光眼之间的关系及研究进展进行综述。     

手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征312例

目的 探讨手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征(obsturctive sleep apnea hypopnea syndrome, OSAHS)的疗效.方法 对312例OSAHS患儿行全身麻醉鼻内镜下腺样体、扁桃体切除联合腭咽成型术,并将本组患儿疗效同175例经传统方法治疗的OSAHS患儿疗效进行比较.结果 术后随访6个月,283例痊愈,7例显效,21例有效,1例无效.与传统方法治疗组比较,痊愈率差异有统计学意义.无一例复发,未见任何局部及全身并发症,无不良反应.149例患儿术后3个月行多道睡眠监测(polysomnography, PSG),结果均较术前明显改善.结论 手术治疗儿童OSAHS可提高其痊愈率,无局部及全身并发症.     

急性原发性房角关闭患者昼夜节律状况的研究

目的 研究急性原发性房角关闭(APAC)患者急性发作前的昼夜节律,调查患者在发作前是否存在昼夜节律紊乱,探讨昼夜节律紊乱与APAC的因果关系。方法 收集2016年2月至2018年1月中山大学中山眼科中心海南眼科医院APAC患者46例(APAC组),可疑原发性房角关闭患者(PACS组)30例和健康对照人群(NC组)40例,均为单眼。所有受试者均接受匹斯堡睡眠质量指数(PSQI)问卷调查,利用相关参数反应昼夜节律,比较3组受试者的睡眠状况。结果 在PSQI总得分参数中,APAC组和PACS组患者总得分均>7分,说明均存在睡眠障碍,且与PACS组和NC组比较,APAC组患者PSQI总得分差异均有统计学意义(均为P<0.05)。PACS组与NC组受试者的PSQI总得分差异无统计学意义(P>0.05)。在睡眠质量参数中,APAC组与NC组受试者差异有统计学意义(P<0.05),与PACS组比较,NC组和APAC组受试者差异均无统计学意义(均为P>0.05)。与PACS组和NC组比较,APAC组患者睡眠时间、睡眠效率、依赖睡眠药物、睡眠紊乱以及白天困倦情况差异均有统计...     

The significance of intraocular pressure elevation during sleep‐related postures

Intraocular pressure and its fluctuations are associated with the development and progression of glaucoma. This review examines the potential for sleep‐related intraocular pressure elevations to contribute to the onset and progression of glaucoma. Also considered is the potential for patient education and appropriate changes in behaviour as a means of reducing exposure to elevated intraocular pressure. A PubMed search using the combination key words ‘glaucoma and sleep’ was conducted. Information was taken from representative articles from the 187 yielded from the search. Additional papers were found after accessing references in selected papers. Several studies have indicated an association between the progression of glaucoma and both lateral decubitus (side sleep) and supine sleep positions. Evidence that prone sleep positions could raise intraocular pressure to high levels suggests a similar if not stronger association. Intraocular pressure elevation and progression of glaucoma associated with sleep positions suggest that there are similar risks of progression associated with sleep‐related body postures adopted during non‐sleep activities, such as reading, watching television and sun‐bathing. Posture‐related management of patients with glaucoma, which is intended to reduce the risk or degree of progression may include the use of specially designed pillows, bed‐head elevation and recommendations to avoid postures which induce higher intraocular pressure.     

Is Genetic Risk for Sleep Apnea Causally Linked With Glaucoma Susceptibility?

PurposeObservational studies have suggested that individuals with pre-existing sleep apnea (SA) have up to double the risk of developing glaucoma than individuals without SA. Understanding risk factors for glaucoma is important to assist with well-structured screening, early intervention, and efficient allocation of specialist consultation. The objective of this study is therefore to use genetic data to determine whether SA is a causal risk factor for glaucoma.MethodsTwo-sample Mendelian randomization (MR) analyses were performed to assess the association between genetically predicted SA and glaucoma susceptibility using genome-wide association study (GWAS) of 25,062 SA cases, 313,372 controls derived from 23andMe and summary data from a glaucoma GWAS meta-analysis (20,582 cases, 119,318 controls), including individuals of European descent, mainly from the UK Biobank.ResultsInverse variance weighted regression of genetic susceptibility for SA on risk of glaucoma revealed no strong evidence for an association between SA and glaucoma (OR = 0.95, 95% confidence intervals = 0.84–1.07), results were consistent across all MR predictors.ConclusionsWe found little genetic evidence supporting a causal association between SA and glaucoma. Our results refute the possibility of a large effect (glaucoma OR > 1.5 per doubling of odds on SA) between SA and glaucoma.     

阻塞性睡眠呼吸暂停低通气综合征气道解剖功能异常的研究进展

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种多病因导致的睡眠呼吸性疾病,其临床表现和并发症涉及医学诸多学科,近年来受到越来越多医师与患者的关注。本文关注OSAHS的发病机制,重点从解剖学角度分析其功能改变,并对其进行综述。     

The effect of cataract surgery on sleep quality: a systematic review and Meta-analysis

AIM: To evaluate the effect of cataract surgery on sleep quality and to compare the difference between ultraviolet-blocking clear intraocular lens (UVB-IOL) and blue-filtering intraocular lens (BF-IOL) implantation. METHODS: Electronic search was performed of PubMed, MEDLINE, Embase and the Cochrane Library up to January 2016. Studies were eligible when they evaluated the sleep quality before and after cataract surgery by Pittsburgh sleep quality index (PSQI). A random/fixed-effects Meta-analysis was used for the pooled estimate. Heterogeneity was assessed with the I2 test. RESULTS: Six studies were selected from 5623 references. Cataract surgery significantly reduced the PSQI scores at postoperative 0-3mo [mean difference (MD) =-0.62, 95%CI: -1.14 to -0.11, P=0.02, I2=66%] and 3-12mo (MD=-0.32, 95%CI: -0.62 to -0.02, P=0.04, I2=0), respectively. Considering different intraocular lens (IOL) implantations, relative post-operative PSQI reduction was found for both UVB-IOL and BF-IOL, but a significant reduction was detected only for UVB-IOL. No significant difference was found with the effect of BF-IOL vs UVB-IOL on sleep quality. CONCLUSION: This study found that cataract surgery significantly improved the PSQI score-derived subjective sleep quality irrespective of the IOL type implanted. These findings highlight a substantial benefit of cataract surgery on systemic health with photoreceptive restoration in addition to visual acuity improvements.     

Reversal of floppy eyelid syndrome with treatment of obstructive sleep apnoea

Purpose : To describe the beneficial effects of treatment of obstructive sleep apnoea on the symptoms and signs of floppy eyelid syndrome. Method : A case of sleep apnoea with associated floppy eyelid syndrome is reported. Results : A 32‐year‐old man presented with left floppy eyelid syndrome and a known diagnosis of obstructive sleep apnoea. He underwent treatment for 4 years with continuous positive airways pressure by mask during sleep and the symptoms and signs of his floppy eyelid syndrome disappeared. Conclusion : Treatment of obstructive sleep apnoea may reverse the changes of floppy eyelid syndrome.