Changes Of Optic Nerve Function And Fundus Microcirculation In Obstructive Sleep Apnoea Hypopnea Syndrome Patients

Objective To investigate the changes of optic nerve function and fundus microcirculation in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）by pattern visual evoked potential（PVEP）and optical coherence tomography angiography（OCTA）,and to find the parameters with early screening and diagnostic value for OSAHS optic neuropathy to avoid irreversible damage to optic nerve function.Methods Prospective case-control studies.A total of 94 patients initially diagnosed with OSAHS in the Sleep Center of the First People’s Hospital of Yunnan Province from June to December 2022 were enrolled.According to the apnea hypopnea index（AHI）,OSAHS patients were divided into 12 cases in the mild OSAHS group,28 cases in the moderate OSAHS group,and 54 cases in the severe OSAHS group.During the same period,40 healthy physical examiners with matching age,sex and body mass index were selected as normal control groups.All subjects underwent overnight polysomnography、pattern visual evoked potential（PVEP）and optical coherence tomography angiography（OCTA）.Compare the differences in the latency of P100(LP₁₀₀)、the amplitude of P100(AP₁₀₀)and the density of radial peripapillary capillaries（RPC）laminar vessels among groups.The Receiver operating characteristic（ROC）curve was drawn,and the correlation between the ophthalmic examination results and sleep monitoring data of the OSAHS group was analyzed.Results1.Compared with the normal control group,patients in the OSAHS group had a significant reduction in AP₁₀₀（P<0.001）:15.13（9.89,17.17）μV in the control group and 9.77（6.81,13.46）μV in the OSAHS group;LP₁₀₀extension（P<0.05）:107（105,109）ms in the control group and 108（105,111）ms in the OSAHS group;RPC vascular density reduction（P<0.05）:0.34±0.07%in the control group and0.32±0.06%in the OSAHS group.There were no significant differences in AP₁₀₀,LP₁₀₀and RPC vascular density among OSAHS groups（P>0.05）.2.The AP₁₀₀in the mild,moderate and severe OSAHS groups was9.55（4.8,14.66）μV,11.88（8.52,14.63）μV and 9.15（6.17,12.53）μV,respectively,which were lower than those in the normal control group[15.13（9.89,17.17）μV],and the difference was statistically significant（P<0.05）;The LP₁₀₀in the severe OSAHS group was 109（105.75,113.25）ms,which was higher than that of the normal control group[107（105,109）ms],and the difference was statistically significant（P<0.05）,and the LP₁₀₀in the mild and moderate OSAHS group was 108.5（102.75,110.75）ms and 107（105,109.75）ms,respectively,which was not statistically significant from the normal control group（P>0.05）;The RPC vascular density in the moderate OSAHS group was 0.3007±0.0674%,which was lower than that of the normal control group（0.3413±0.0715%）,and the difference was statistically significant（P<0.05）,and the RPC vascular density in the mild and severe OSAHS group was0.3242±0.0605%and 0.3209±0.0583%,respectively,which was not statistically significant from the normal control group（P>0.05）.3.The ROC curve plot of P100 wave latency time,amplitude and RPC vessel density showed that the area under the AP₁₀₀curve was 0.718,and the optimal critical value was 13.695μV.The sensitivity was 77.7%,the specificity was 60%;the area under the LP₁₀₀curve was 0.388,the optimal cut-off value was 101.5ms,the sensitivity was 5.3%,and the specificity was 95%;the area under the RPC vascular density curve was 0.604,the optimal cut-off value was 0.39615%,the sensitivity was92.6%,and the specificity was 30%.Conclusion1.The risk of abnormal optic nerve function and fundus microcirculation in OSAHS patients is increased compared with normal people,suggesting that patients with OSAHS need to pay attention to ocular-related changes to avoid irreversible damage to optic nerve function.2.The ROC curve suggests that AP₁₀₀has certain early warning value for early screening and diagnosis of optic neuropathy in OSAHS patients,which can provide help for early visual function detection and follow-up of OSAHS patients,RPC vascular density has low value for early screening and diagnosis of optic neuropathy in OSAHS patients,while LP₁₀₀is not sensitive to early screening and diagnosis of optic neuropathy in OSAHS patients.