The Changes Of Ocular Blood Flow In Patients With Obstructive Sleep Apnea-hypopnea Syndrome

Objective:â‘´To observation the ophthalmic artery(OA),central retinal artery(CRA)and posterior ciliary artery(PCA)blood flow in patients with obstructive sleep apnea-hypopnea syndrome (OSAS);⑵Detected the nitric oxide (NO),endothelin-1(ET-1) and its relationship withblood flow results;⑶Further observed ocular blood flow in OSAS through guidance Mueller manoeuvre simulation obstructive sleep apnea event,discussion the changes of eye vascular autoregulation with using the slope index.Methods:To select randomly 15 health male adult in examination center as normal control,to select randomly 42 patients with OSAS with PSG in sleep detection center,the OSAS patients was divided into mild 14 patients,moderate and severe 28 patients groups based on the apnea-hypopnea index(AHI).All subjects write the same sleep questionnaire and to carry out polysomnogram monitoring all night for 7 hours at least;collectingempty stomach peripheral venous blood in two test tube at 7 am on next day.To examin the level of NO and ET-1;to determination the end-tidal CO₂(ETCO₂) and intraocular pressure measurement and color doppler sonography on next day,to record the data in the inspection process before and after Mueller manoeuvre. All data were analyzed statistically.Results:â‘´AHI, min oxygen saturation(SaO₂min),(percentage of the time that oxygen saturation below than 90%)SLT90 and (micro-arousal index)MAI in the each group have statistical significance (P<0.05),compared with non and mild OSAS group,moderate and severe OSAS group the longest time of apnea (LA) and (mean oxygen saturation)SaO₂mean have statistical significance (P<0.05);⑵NO in the each group have statistical significance (P<0.05);compared with non and mild OSAS group,moderate and severe OSAS group ET-1 and ETCO₂ have statistical significance (P<0.05);before and after Mueller manoeuvre ETCO₂ pairwise comparison have statistical significance (P<0.05);⑶Compared with non-OSAS group,moderate and severe OSAS group the diameter of OA and PCA and CRA(peak systolic velocity)PSV have statistical significance (P<0.05),CRA(end diastolic velocity)EDV in the each group have statistical significance (P<0.05),compared with non and mild OSAS group,moderate and severe OSAS group PCAPSV and PCAEDV have statistical significance (P<0.05);â‘·Compared with non and mild OSAS group,moderate and severe OSAS group CRAEDV and PCAPSV have statistical significance (P<0.05),PCAEDV in the each group have statistical significance (P<0.05);⑸The diameter of OA and PCA correlated negatively with ETCO₂ (r=-0.41 and -0.34,P<0.05), CRAPSV correlated with ET-1 and SaO₂min (r=0.63 and -0.37,P<0.05),CRAEDV correlated with NO, ETCO₂ and SaO₂mean (r=-0.59,0.57 and -0.39,P<0.05),PCAPSV correlated with ET-1, SaO₂min and MAI (r=0.51,-0.34 and 0.56,P<0.05),PCAEDV correlated ET-1,SaO₂min and MAI (r=0.48,-0.29 and 0.61,P<0.05).Conclusions:â‘´The diameter and blood flow of OA, PCA and CRA has changed in OSAS patients;⑵Compared with non-OSAS patients,The autoregulation function of PCA and CRA has weakened in OSAS patients;⑶Ocular blood flow may be affected by NO,ET-1,ETCO₂ and other factors in OSAS patients.