Retinochoroidal structural alterations in obstructive sleep apnea: A spectral domain optical coherence tomography study.

Abstract

Purpose: The purpose of this study was to analyze retinochoroidal parameters in patients with obstructive sleep apnea syndrome (OSAS) using spectral-domain optical coherence tomography (SD-OCT) and evaluate their relationship with disease severity.

Materials and methods: This cross-sectional observational study included 60 OSAS patients diagnosed by overnight polysomnography and 60 age-matched healthy controls. The OSAS group was subdivided based on apnea-hypopnea index into mild (n = 18), moderate (n = 28), and severe (n = 14) categories. SD-OCT measurements included retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, subfoveal choroidal thickness, and central macular thickness.

Results: OSAS patients showed significant thinning in average RNFL (94.7 ± 7.84 μm vs. 98.93 ± 7.67 μm, 95% confidence interval [CI]: 1.43-7.03, P = 0.003) and GC-IPL thicknesses (80.03 ± 3.11 μm vs. 82.1 ± 2.05 μm, 95% CI: 1.12-3.02, P < 0.001) compared to controls. Severity-based analysis revealed progressive thinning across all parameters, with the strongest correlations observed between disease severity and GC-IPL (r = -0.979) and RNFL parameters (r = -0.922). The most significant differences were consistently found between mild and severe OSAS groups (P < 0.001).

Conclusion: Significant retinochoroidal alterations occur in OSAS patients, with changes correlating to disease severity. The distinctive pattern of retinal layer thinning, particularly in superotemporal RNFL and superior GC-IPL, demonstrates an association with OSAS severity.