The Research Of The Correlation Between Obstructive Sleep Apnea-Hypopnea Syndrome And Conjunctivochalasis And Changes Of Cytokines In Tears

Purpose To study the correlation of Obstructive sleep apnea hypopnea syndrome(OSAHS)and conjunctivochalasis(CCh),and the correlation of the incidence of CCh and floppy eyelid in OSAHS patients.To study tear cytokine changes in OSAHS patients,inorder to declear the relationship between OSAHS and ocular surface disease,such as CCh.Methods Forty patients took part in polysomnography from Mar.2019 to Sep.2019 were enrolled in this study.Personal informations,apnea-hypopnea index(AHI),minimum blood oxygen saturation were recorded and analysed.According to the outcome of the polysomnography,they were divided into four groups,the normal group,the mild OSAHS group,the moderate OSAHS group and the severe OSAHS group.The degree of CCh and floppy eyelid were recorded,and the four cytokines,IL-6,IL-8,TNF-α and EGF collected from tears were analyzed.SPSS21.0 software was used for data analysis.Results 1.Eighty eyes of 40 patients were enrolled in this study,including 32 males and 8 females.The average age of the patients was 42.33±13.05 years old,and there was no statistically significant difference in age and gender among the groups of patients with the normal group,mild OSAHS,moderate OSAHS and severe OSAHS group(P > 0.05).2.The incidence of CCh in 40(80 eyes)patients was 93.75%(75/80).The incidence of CCh in the normal group,mild OSAHS,moderate OSAHS,severe OSAHS was 85.7%(12/14),88.89%(16/18),93.75%(15/16)and 100%(32/32)respectively.The degree of CCh were different in the normal group,mild OSAHS,moderate OSAHS,and severe OSAHS groups(P < 0.05).By Spearman correlation analysis,the r correlation coefficient was 0.33,P =0.01(P < 0.05).3.Spearman correlation analysis showed that the r correlation coefficient of AHI value and CCh was 0.373,p=0.001(P < 0.05).The r correlation coefficient of the longest pause interval and CCh was 0.693,P < 0.001(P < 0.05).The r correlation coefficient of the lowest blood oxygen saturation and CCh was-0.487,P < 0.001(P < 0.05).4.66 eyes of 33 patients with OSAHS,the incidence of CCh was 95.45%(63/66)and CCh combined with floppy eyelid was 77.27%(51/63).GradeⅠCCh risk of floppy eyelid rate was 47.62%(10/21),grade Ⅱ CCh risk of floppy eyelid rate was 97.06%(33/34),grade Ⅲ CCh with floppy eyelid rate was 100.00%(8/8).The level of floppy eyelid was not completely the same in the different levels of CCh patients(P<0.001).After Spearman correlation analysis,the r coefficient was 0.687 and P <0.01.5.In this study,the levels of IL-6,IL-8,TNF-α,and EGF in the tear of the patients were not identical in the groups of the normal group,mild OSAHS,moderate OSAHS,and severe OSAHS goups(H values of 72.005,47.764,16.180,19.558,all P < 0.001).Among them,the level of IL-6 in tears of patients with severe OSAHS was higher than that of the normal group,mild OSAHS,and moderate OSAHS.The level of IL-8in tears of moderate and severe OSAHS was higher than that of the normal group,mild OSAHS.The levels of TNF-α and EGF in the tears of patients with moderate and severe OSAHS were higher than those of the normal group,and the differences were statistically significant(P < 0.05).Conclusions CCh is correlated with the severity of OSAHS.The more severe OSAHS is,the higher the grade of CCh is.The higher the grade of CCh in OSAHS patients,the higher the grade of floppy eyelid in OSAHS patients.There may be a certain relationship between Cytokines and the occurrence and development of ocular surface diseases such as CCh in OSAHS patients.