Benefit of continuous positive airway pressure on optic nerve damage in patients with obstructive sleep apnea.

IF 2 4区 医学 Q3 CLINICAL NEUROLOGY
Teresa Diaz de Terán, Ignacio Boira, Andrea Cerveró, Alfonso Casado, Alicia Lopez-de-Eguileta, Soraya Fonseca, Pedro Muñoz, Claudia Nebot, Antonello Nicolini, Paolo Banfi, Paolo Solidoro, Mónica González
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Abstract

Purpose: The purpose of our study was to evaluate the effectiveness of CPAP in increasing the thickness of retinal layers. Other aims were to assess retinal and optic nerve damage predictors in OSA and establish predictors of poor response to CPAP treatment in optic nerve damage.

Methods: A prospective cohort study with consecutive inclusion of the first 3 patients who attended for treatment each day. All patients underwent a diagnostic polygraph, and patients with moderate-severe OSA treated with CPAP were recruited. Optical Coherence Tomography (OCT) was performed within 3 days of the patient's inclusion and 12 months after the start of CPAP treatment.

Results: Data from 37 patients with OSA were analysed. After 12 months of CPAP treatment, there was a significant improvement in the thickness of the superotemporal Bruch's membrane opening-minimum rim width (BMO-MRW) (316.54 to 318.23 μm, p-value = 0.08). There was a non-significant improvement in the thickness of nasal, inferonasal and superonasal retinal nerve fibre layers. In a multivariate analysis, HB and Type 2 diabetes mellitus have been associated with an increased odds ratio (OR) of retinal and optical nerve damage (OR = 3.58, p = 0.03 and OR = 4.344, p = 0.042, respectively).

Conclusion: BMO-MRW thickness may assess early damage induced by OSA and the response to CPAP. HB is a predictor of retinal and optic nerve damage in patients with OSA. CPAP treatment has a long-term protective effect on the retina and optic nerve.

Abstract Image

Abstract Image

持续气道正压通气对阻塞性睡眠呼吸暂停患者视神经损伤的益处。
目的:本研究的目的是评价CPAP在增加视网膜层厚度方面的有效性。其他目的是评估OSA患者视网膜和视神经损伤的预测因素,并建立对CPAP治疗视神经损伤不良反应的预测因素。方法:前瞻性队列研究,连续纳入每天就诊的前3例患者。所有患者都进行了诊断测谎,并招募了接受CPAP治疗的中重度OSA患者。光学相干断层扫描(OCT)在患者入组后3天和开始CPAP治疗后12个月内进行。结果:对37例OSA患者的资料进行分析。CPAP治疗12个月后,颞上布鲁氏膜开口-最小边缘宽度(BMO-MRW)厚度显著改善(316.54 ~ 318.23 μm, p值= 0.08)。鼻、鼻间和鼻上视网膜神经纤维层厚度无明显改善。在一项多变量分析中,HB和2型糖尿病与视网膜和视神经损伤的优势比(OR)增加相关(OR分别= 3.58,p = 0.03和OR = 4.344, p = 0.042)。结论:BMO-MRW厚度可评价OSA的早期损伤及对CPAP的反应。HB是OSA患者视网膜和视神经损伤的预测指标。CPAP治疗对视网膜和视神经有长期的保护作用。
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来源期刊
Sleep and Breathing
Sleep and Breathing 医学-呼吸系统
CiteScore
5.20
自引率
4.00%
发文量
222
审稿时长
3-8 weeks
期刊介绍: The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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