OBJECTIVE Obstructive sleep apnea/hypopnea syndrome (OSA) could compromise oxygenation of the optic nerve and cause glaucomatous optic neuropathy; there has been no study to investigate the microstructure changes of the optic nerve and retina in OSA patients before and after continuous positive airway pressure (CPAP) therapy. In this study, we assess whether treatment with CPAP might improve visual sensitivity and retinal thickness in patients with OSA. METHODS Patients with OSA were prospectively recruited and referred for ophthalmologic evaluation at baseline and three months after CPAP treatment. Each patient underwent an ophthalmological exam, standard automated perimetry (SAP), and optical coherence tomography (OCT) exam. Peripapillary retinal nerve fiber layer (RNFL) and macular layer (ML) thickness parameters were measured. The SAP, RNFL, and ML thickness parameters before and after treatment were compared. RESULTS A total of 32 OSA patients were consecutively enrolled. At baseline, the mean deviation (MD) of SAP was -2.15 ± 1.90 dB (dB). After CPAP treatment, the MD was -1.38 ± 1.37 dB (p = 0.017). Regarding the OCT parameters, the inferior quadrant and nasal-inferior sector of RNFL thickness significantly improved after treatment (p = 0.025 and 0.004, respectively). The ML thickness in the superior-inner sector, inferior-outer sector, nasal-outer sector, superior hemisphere, and inferior hemisphere were also significantly improved after treatment. Improvement of ML thickness in the superior-inner sector positively correlated with the apnea/hypopnea index (r = 0.405, p = 0.022) and desaturation index (r = 0.473, p = 0.006) on pre-treatment polysomnography. CONCLUSION The treatment of CPAP could improve visual sensitivity and increase retinal thickness in patients with OSA.

中文翻译：

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CPAP对OSA患者的视觉敏感性和视网膜厚度的影响。

目的阻塞性睡眠呼吸暂停/呼吸不足综合征（OSA）可能损害视神经的氧合并引起青光眼性视神经病变。尚无研究调查连续气道正压通气（CPAP）治疗前后OSA患者视神经和视网膜的微结构变化。在这项研究中，我们评估了CPAP治疗是否可以改善OSA患者的视觉敏感性和视网膜厚度。方法前瞻性招募OSA患者，并在基线和CPAP治疗后三个月转诊接受眼科评估。每位患者均接受眼科检查，标准自动视野检查（SAP）和光学相干断层扫描（OCT）检查。测量了乳头周围视网膜神经纤维层（RNFL）和黄斑层（ML）的厚度参数。SAP，RNFL，比较处理前后的ML厚度参数。结果共有32例OSA患者被连续纳入。在基线时，SAP的平均偏差（MD）为-2.15±1.90 dB（dB）。经CPAP治疗后，MD为-1.38±1.37 dB（p = 0.017）。关于OCT参数，治疗后RNFL厚度的下象限和鼻下下部明显改善（分别为p = 0.025和0.004）。治疗后，上内，下外，鼻外，上半球和下半球的ML厚度也显着改善。预处理多导睡眠图时，上，内层ML厚度的改善与呼吸暂停/呼吸不足指数（r = 0.405，p = 0.022）和去饱和指数（r = 0.473，p = 0.006）呈正相关。