Choroidal vascular and oropharyngeal morphological indicators in predicting CPAP treatment efficacy in severe OSAS patients: a prospective cohort study.

Abstract

Objective: The goal of this paper is to explore the value of choroidal vascular and oropharyngeal morphological indicators in predicting the efficacy of Continuous Positive Airway Pressure (CPAP) treatment in patients with severe Obstructive Sleep Apnea Syndrome (OSAS).

Methods: A total of 245 patients with severe OSAS between January 2022 and June 2024 from a hospital, treated with CPAP, were enrolled. Patients were divided into two groups based on treatment efficacy: the Good response group and the Poor response group. Choroidal vascular indicators [subfoveal choroidal thickness (SF-CT), choriocapillaris vessel density (CC-VD), choroidal vascularity index (CVI)] and oropharyngeal morphological indicators [posterior nasal spine to menton distance (PNS-Me), hyoid-mental distance (HMD), soft palate length (posterior nasal spine to uvular tip point, PNS-P1)] were compared between the two groups. Receiver Operating Characteristic (ROC) curves were drawn to analyze the predictive efficacy of these indicators for CPAP treatment in severe OSAS patients. A nomogram and calibration curve were created to develop a prediction model for CPAP treatment efficacy in severe OSAS patients.

Results: In the Poor response group, the longest apnea duration (LAD), percentage of time with oxygen saturation < 90% (TS90%), and apnea-hypopnea index (AHI) were all significantly higher than those in the Good response group. The lowest arterial oxygen saturation (LSaO2) was notably lower in the Poor response group compared to the other one (P < 0.05). The area under the curve (AUC) values of SF-CT, CC-VD, and CVI for predicting the outcome of IBD patients were 0.835, 0.805, and 0.910, respectively. The AUC values of PNS-Me, HMD, and PNS-P1 were 0.897, 0.937, and 0.898, respectively. In addition, the nomogram prediction model constructed with choroidal vascular and oropharyngeal morphology indicators had high accuracy.  CONCLUSION: Choroidal vascular and oropharyngeal morphological indicators have a good predictive effect on CPAP treatment efficacy in patients with severe OSAS.