Purpose

The relation between OSAS and eye diseases is well known in adults, while very few and contradictory data can be found regarding paediatric ages. The aim of this study is to explore the early corneal, macular and optic nerve changes in paediatric patients with OSAS.

Methods

Prospective study that enrolled children aged ≥ 4 years referred to the Paediatric Pneumology Clinic in Verona for suspected obstructive sleep apnoea syndrome (OSAS) and investigated with the overnight respiratory polygraphy. Patients with apnoea–hypopnea index (AHI) > 1 were classified as OSAS, while those with AHI < 1 were classified non-OSAS. All patients underwent comprehensive eye examination including slit lamp, refraction, intraocular pression (Goldman applanation tonometry), corneal tomography (corneal astigmatism, corneal keratometry at the apex, surface asymmetry index, central corneal thickness and thinnest corneal thickness) and optical coherence tomography (central macular thickness, macular volume and retinal nerve fibre layer).

Results

Seventy-two children were enrolled in the study. The overall prevalence of OSAS was 48.6%. Statistically significant differences were found between OSAS and non-OSAS group for corneal asymmetry (0.9 ± 0.5 and 0.6 ± 0.3, respectively; p = 0.02), thinnest corneal thickness (551.8 ± 33.9 and 563.7 ± 32.5; p = 0.04), average retinal nerve fibre layer (102.8 ± 10.5 µm and 98.1 ± 12.3 µm; p = 0.012) and in nasal quadrant (76.2 ± 15.4 µm and 66.5 ± 12.6 µm; p = 0.0002).

Conclusions

A comprehensive eye examination with corneal and optic nerve imaging showed early corneal and optic nerve changes in children newly diagnosed with OSAS. These could be prelude of the known ocular manifestations associated with OSAS in adult patients.

中文翻译：

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受阻塞性睡眠呼吸暂停综合征影响的儿科人群的早期角膜和视神经变化

目的

OSAS 与眼病之间的关系在成人中是众所周知的，而关于儿科年龄的数据却很少且相互矛盾。本研究的目的是探讨 OSAS 儿科患者的早期角膜、黄斑和视神经变化。

方法

纳入 4 岁以上儿童的前瞻性研究因疑似阻塞性睡眠呼吸暂停综合征 (OSAS) 转诊到维罗纳的儿科肺科诊所，并通过夜间呼吸测谎进行调查。呼吸暂停-低通气指数 (AHI) > 1 的患者被归类为 OSAS，而 AHI < 1 的患者被归类为非 OSAS。所有患者均接受了全面的眼科检查，包括裂隙灯、屈光度、眼压（Goldman applanation tonometry）、角膜断层扫描（角膜散光、顶点角膜角膜曲率、表面不对称指数、中央角膜厚度和最薄角膜厚度）和光学相干断层扫描（中央黄斑厚度、黄斑体积和视网膜神经纤维层）。

结果

七十二名儿童参加了这项研究。OSAS 的总体患病率为 48.6%。OSAS 组和非 OSAS 组的角膜不对称性（分别为 0.9 ± 0.5 和 0.6 ± 0.3；p  = 0.02）、最薄角膜厚度（551.8 ± 33.9 和 563.7 ± 32.5；p  = 0.04）、平均视网膜神经纤维层（102.8 ± 10.5 µm 和 98.1 ± 12.3 µm；p  = 0.012）和鼻象限（76.2 ± 15.4 µm 和 66.5 ± 12.6 µm；p  = 0.0002）。

结论

角膜和视神经成像的全面眼科检查显示新诊断为 OSAS 的儿童早期角膜和视神经发生变化。这些可能是与成年患者 OSAS 相关的已知眼部表现的前奏。