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Early corneal and optic nerve changes in a paediatric population affected by obstructive sleep apnea syndrome

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Abstract

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.

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Abbreviations

AASM:

American academy of sleep medicine

AHI:

Apnoea–hypopnea index

AK:

Corneal keratometry at the apex

BMI:

Body mass index

CCT:

Central corneal thickness

CMT:

Central macular thickness

IOP:

Intraocular pressure

MV:

Macular volume

OSAS:

Obstructive sleep apnoea syndrome

ODI:

Oxygen desaturation index

RP:

Respiratory polygraphy

RNFL:

Retinal nerve fibre layer

SAI:

Surface asymmetry index

SDB:

Sleep disordered breathing

SD-OCT:

Spectral domain optical coherence tomography

SE:

Spherical equivalent

TCT:

Thinnest corneal thickness

TST:

Total sleep time

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Acknowledgements

The corresponding author affirms that all those who contributed significantly to the work are listed.

Funding

No financial assistance was received in support of the study.

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Authors and Affiliations

  1. Eye Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Pz.Le LA Scuro 10, 37100, Verona, VR, Italy

    Erika Bonacci, Adriano Fasolo, Tommaso Merz, Giacomo Brocoli, Rosa Longo, Francesca Bosello, Giorgio Marchini & Emilio Pedrotti

  2. Eye Clinic, Department of Sense Organs, Sapienza University of Rome, Pz.Le A Moro 5, 00185, Rome, RM, Italy

    Giacomo Brocoli

  3. Ophthalmic Unit, San Bassiano Hospital, Via dei Lotti, 40, 36061, Bassano del Grappa, VI, Italy

    Alessandra De Gregorio

  4. Pediatric Division, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Piazzale Stefani 1, 37126, Verona, VR, Italy

    Marco Zaffanello, Angelo Pietrobelli & Maria Clemente

Authors
  1. Erika Bonacci
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  2. Adriano Fasolo
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  3. Marco Zaffanello
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  4. Tommaso Merz
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  5. Giacomo Brocoli
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  6. Angelo Pietrobelli
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  7. Maria Clemente
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  8. Alessandra De Gregorio
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  9. Rosa Longo
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  10. Francesca Bosello
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  11. Giorgio Marchini
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  12. Emilio Pedrotti
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Corresponding author

Correspondence to Francesca Bosello.

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Ethics approval

All procedures performed in the study were in accordance with the ethical standards of the institutional and national ethic committee.

Informed consent

Informed consent was obtained from the parents of all individual participants included in the study.

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Bonacci, E., Fasolo, A., Zaffanello, M. et al. Early corneal and optic nerve changes in a paediatric population affected by obstructive sleep apnea syndrome. Int Ophthalmol 42, 1281–1287 (2022). https://doi.org/10.1007/s10792-021-02115-2

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  • DOI: https://doi.org/10.1007/s10792-021-02115-2

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