Lamina cribrosa curvature index as a biomarker of non-glaucomatous optic neuropathy in obstructive sleep apnea syndrome.

Abstract

Purpose: The aim of this study was to evaluate retinal nerve fiber layer (RNFL), radial peripapillary capillary plexus (RPCP), and lamina cribrosa (LC) parameters in patients diagnosed with obstructive sleep apnea syndrome (OSAS) and healthy controls and to investigate the relationship between these parameters and OSAS severity.

Methods: This prospective case-control study included 124 eyes from 124 OSAS patients (mild: n = 24, moderate: n = 45, severe: n = 55) diagnosed by polysomnography and 104 eyes of 104 healthy individuals. RNFL thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, RPCP vessel densities (VD), LC thickness (LCT), LC depth, LC anterior width, LC curvature depth, and LC curvature index (LCCI) were assessed using swept-source optical coherence tomography and optical coherence tomography angiography. Comparisons among groups and correlation analyses were performed.

Results: RNFL thickness and RPCP VD were significantly lower in OSAS patients compared to healthy controls (P < 0.05). No significant differences were observed among groups in GCIPL thickness. Among LC parameters, LCCI was significantly higher in severe and moderate OSAS groups compared to healthy controls (P < 0.05). Moreover, a positive correlation was found between apnea-hypopnea index and LCCI, while a negative correlation was noted between AHI and LCT (P = 0.013 and P = 0.005, respectively).

Conclusion: LC parameters, particularly LCCI, may serve as important indicators reflecting disease severity and potential structural alterations at the optic nerve head in OSAS patients. LCCI may have clinical utility in assessing early optic neuropathy risk in OSAS. Further large-scale, prospective studies are warranted to validate these findings.