Effect Of Obstructive Sleep Apnea Hypopnea Syndrome On Visual Field、Nerve Fiber Layer And Ocular Surface

OBJECTIVE:Analysis of the relationship between obstructive sleep apnea hypopnea syndrome（OSAHS）and visual field、nerve fiber layer、ocular surface diseases.METHODS:A collection of 45 patients who were diagnosed with OSAHS by polysomnography（PSG）in the sleep room of the respiratory department and were not treated by ventilator were in the OSAHS group（experimental group）.At the same time,30 normal people whose gender and age matching、without underlying diseases and with low risk as a result of Berlin questionnaire survey were selected as the non-OSAHS group（normal control group）.Both the experimental group and the control group underwent intraocular pressure、visual field、RNFL thickness around the optic disc and ocular surface analysis to compare the differences between the two groups.According to the apnea hypopnea index（AHI）,OSAHS is divided into three groups,mild group、moderate group、and severe group,compare the differences between the three groups in intraocular pressure、visual field、RNFL thickness around the optic disc and ocular surface analysis.And analyze the correlation between AHI、RNFL and body mass index（BMI）,minimum blood oxygen saturation at night（L-Sa O₂）,and average blood oxygen saturation at night（M-Sa O₂）.RESULTS:1.Compared with the non-OSAHS group,the intraocular pressure of the OSAHS group was not statistically significant（P>0.05）,and the mean defect（MD）and pattern standard deviation（PSD）of the OSAHS group were statistically significant（P<0.05）.2.The average、superior、inferior、and temporal RNFL thickness of both eyes in the OSAHS group were significantly lower than those in the non-OSAHS group,and the difference was statistically significant（P<0.05）.The nasal RNFL thickness of both eyes was not significantly different between the two groups（P>0.05）.3.There were significant differences in the rate of eyelid gland loss、conjunctival hyperemia index and tear break-up time（TBUT）between the OSAHS group and the non-OSAHS group,and the difference was statistically significant（P<0.05）,while the tear meniscus height between the two groups had no statistical significance（P>0.05）.4.The OSAHS group was divided into mild、moderate and severe groups,after comparing the three groups,it was found that gender、M-Sa O2、L-Sa O2、and binocular conjunctival hyperemia index were statistically significant（P<0.05）.After further comparison of M-Sa O₂、L-Sa O₂ and binocular conjunctival hyperemia index:（1）In L-Sa O₂ index,there was statistical significance between mild group and severe group;（2）In the M-Sa O₂ index,there was statistical significance between mild group and severe group;（3）In the conjunctival hyperemia index of left eye,there was statistical significance in the mild group、the moderate group and the severe group;in the conjunctival hyperemia index of right eye,there was statistical significance between the mild group and the severe group.5.In the OSAHS group,Spearman correlation analysis of RNFL and related factors showed that the thickness of RNFL on the nasal side of the right eye was negatively correlated with BMI（correlation coefficient r=-0.380,P<0.05）.Binocular average、superior、inferior and temporal RNFL and the nasal RNFL of left eye were not correlated with AHI,M-Sa O2,L-Sa O2.6.In the correlation analysis between AHI and other factors,AHI was positively correlated with BMI（correlation coefficient r=0.334,P<0.05）,AHI was negatively correlated with M-Sa O₂（correlation coefficient r=-0.488,P<0.05）,and AHI was negatively correlated with L-Sa O₂（correlation coefficient r=-0.413,P<0.05）.CONCLUSIONS:1.OSAHS patients are more likely to have visual field damage,thinning of RNFL and ocular surface damage than normal people,which may be high risk factors for optic neuropathy and ocular surface diseases;2.The RNFL on the nasal side of the right eye is negatively correlated with BMI.The thinning of RNFL may be related to the increase of BMI.