Retinal abnormalities, although relatively common in sleep clinic patients referred for polysomnography, are largely unrelated to sleep-disordered breathing,Sleep and Breathing

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Retinal abnormalities, although relatively common in sleep clinic patients referred for polysomnography, are largely unrelated to sleep-disordered breathing
Sleep and Breathing ( IF 2.1 ) Pub Date : 2022-07-08 , DOI: 10.1007/s11325-022-02679-y
Terence C Amis _{1,

2,

3} , Rita Perri _{1,

3} , Sharon Lee _{1,

3} , Meredith Wickens _{1,

3} , Gerald Liew _{2,

4,

5} , Paul Mitchell _{2,

4,

5} , Kristina Kairaitis _{1,

2,

3} , John R Wheatley _{1,

2,

3}

Affiliation

Study objectives.

There has been long-standing interest in potential links between obstructive sleep apnea (OSA) and eye disease. This study used retinal photography to identify undiagnosed retinal abnormalities in a cohort of sleep clinic patients referred for polysomnography (PSG) and then determined associations with PSG-quantified sleep-disordered breathing (SDB) severity.

Methods

Retinal photographs (n = 396 patients) were taken of each eye prior to polysomnography and graded according to validated, standardized, grading scales. SDB was quantified via in-laboratory polysomnography (PSG; n = 385) using standard metrics. A questionnaire (n = 259) documented patient-identified pre-existing eye disease. Within-group prevalence rates were calculated on a per patient basis. Data were analyzed using multivariate logistic regression models to determine independent predictors for retinal abnormalities. P < 0.05 was considered significant.

Results

Main findings were (1) 76% of patients reported no pre-existing “eye problems”; (2) however, 93% of patients had at least one undiagnosed retinal photograph-identified abnormality; (3) most common abnormalities were drusen (72%) and peripapillary atrophy (PPA; 47%); (4) age was the most common risk factor; (5) diabetes history was an expected risk factor for retinopathy; (6) patients with very severe levels of SDB (apnea hypopnea index ≥ 50 events/h) were nearly three times more likely to have PPA.

Conclusion

Retinal photography in sleep clinic settings will likely detect a range of undiagnosed retinal abnormalities, most related to patient demographics and comorbidities and, except for PPA, not associated with SDB. PPA may be indicative of glaucoma, and any association with severe SDB should be confirmed in larger prospective studies.

中文翻译：

视网膜异常虽然在接受多导睡眠图检查的睡眠门诊患者中相对常见，但在很大程度上与睡眠呼吸障碍无关

学习目标。

长期以来，人们一直对阻塞性睡眠呼吸暂停 (OSA) 与眼病之间的潜在联系感兴趣。这项研究使用视网膜摄影术来识别一组转诊进行多导睡眠图 (PSG) 的睡眠门诊患者中未确诊的视网膜异常，然后确定与 PSG 量化的睡眠呼吸障碍 (SDB) 严重程度的关联。

方法

在多导睡眠图检查之前对每只眼睛拍摄视网膜照片（n = 396 名患者），并根据经过验证的标准化分级量表进行分级。SDB 使用标准指标通过实验室内多导睡眠图（PSG；n = 385）进行量化。一份调查问卷 ( n = 259) 记录了患者确定的既往眼病。组内患病率是根据每位患者计算的。使用多变量逻辑回归模型分析数据以确定视网膜异常的独立预测因子。P < 0.05 被认为是显着的。

结果

主要发现是 (1) 76% 的患者报告没有预先存在的“眼睛问题”；(2) 然而，93% 的患者至少有一种未确诊的视网膜照片异常；(3) 最常见的异常是玻璃膜疣 (72%) 和周围毛细血管萎缩 (PPA; 47%)；(4) 年龄是最常见的危险因素；(5) 糖尿病史是视网膜病变的预期危险因素；(6) SDB 水平非常严重的患者（呼吸暂停低通气指数≥ 50 次/小时）患 PPA 的可能性高出近三倍。