阻塞性睡眠呼吸暂停综合征对视野及视神经纤维层厚度的影响

目的：探讨阻塞性睡眠呼吸暂停综合征(OSAS)对患者视野及视网膜神经纤维层(RNFL)厚度的影响。

方法：OSAS患者74例74眼及72名健康体检者(72眼)作为对照组被纳入研究。采用Humphrey自动视野计检测视野敏感度(VFS)，采用频域光学相干断层扫描仪(OCT)测量视盘周围RNFL厚度。VFS及视盘周围RNFL被划分为上方、下方、颞侧及鼻侧区域。按照多导睡眠图(PSG)监测获得的呼吸暂停低通气指数(AHI)对OSAS病情进行分级。将29例轻度、25例中度及20例重度OSAS患者上方、下方、颞侧和鼻侧区域的VFS及RNFL厚度分别与对照组进行统计学比较。

结果：OSAS组与对照组上方、下方、颞侧和鼻侧区域的VFS均无差异(P>0.05)。OSAS组尤其是重度OSAS患者视盘鼻侧RNFL厚度较对照组降低(P=0.047)。Pearson相关性分析显示鼻侧RNFL厚度与OSAS患者病情呈负相关(r=-0.9998，P=0.0138)。

结论：重度OSAS可导致鼻侧RNFL厚度减少，RNFL厚度可作为评估OSAS病情严重程度的指标之一。

Effect of obstructive sleep apnea syndrome on visual field and retinal nerve fiber layer thickness

AIM: To determine the effect of obstructive sleep apnea syndrome(OSAS)on visual field and retinal nerve fiber layer(RNFL)thickness.

METHODS: This study consisted of 72 eyes of 72 OSAS patients who were enrolled as OSAS group, and compared with 74 eyes of 74 age-matched physical examination personnels who were enrolled as control group. Visual field sensitivities(VFS)were explored with Humphrey perimeter. Peripapillary RNFL thickness was measured by stratus optical coherence tomography(OCT). VFS and Peripapillary RNFL were divided into upper, lower, temporal and nasal regions. According to apnea-hypopnea index(AHI)scores monitored by polysomnography(PSG), VFS and peripapillary RNFL thickness in 29 patients with mild OSAS, 25 patients with moderate OSAS and 20 patients with severe OSAS were compared with those in control group.

RESULTS: There was no significant difference in VFS between OSAS group and control group in upper, lower, temporal and nasal regions(P>0.05). RNFL of nasal region in OSAS group, especially in severe OSAS patients, was significantly lower than that in control group(P=0.047). Pearson correlation analysis showed that there was negative correlation between RNFL and OSAS severity in nasal region(r= -0.9998, P=0.0138).

CONCLUSION: Severe OSAS may lead to nasal RNFL thickness reduction, and the change of RNFL thickness may be used as one of the indicators to assess the severity of OSAS.