Relationship between obstructive sleep apnea syndrome and central serous chorioretinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Luxi ¹ ,  Zhang Peng ¹ , Wang Yanhui ² , Chen Lian ¹ , Lei Min ¹ , He Ke ¹ , Li Xiaoqing ¹ , Jiang Zhao ¹

1. Department of Ophthalmology, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an 710018, China;
2. Department of Otorhinolaryngology, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an 710018, China;

Corresponding author：

Zhang Peng, Email: zhangpengfmmu@163.com

Keywords：

Central serous chorioretinopathy/etiology; Sleep apnea, obstructive

DOI：

10.3760/cma.j.cn511434-20190507-00171

Video：

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Objective To observe the correlation between obstructive sleep apnea syndrome (OSAS) and central serous chorioretinopathy (CSC).Methods From October 2016 to December 2018, 50 cases of CSC patients (CSC group) and 50 healthy people (control group) matched by age and sex who were diagnosed in the ophthalmological examination of Xi’an No.3 Hospital were included in the study. According to the course of the disease, CSC was divided into acute phase and chronic phase, with 20 and 30 cases respectively. The average age (Z=1.125) and body mass index (BMI) (Z=0.937) of the two groups were compared, and the difference was not statistically significant (P＞0.05); the age of patients with different courses of CSC (Z=1.525) and gender composition ratio (χ²=0.397) and BMI (Z=1.781) were compared, the difference was not statistically significant (P＞0.05). The Berlin questionnaire was used to assess the OSAS risk of subjects in the CSC group and the control group; polysomnography was used to monitor the apnea-hypopnea index (AHI) and minimum blood oxygen saturation (MOS) during night sleep. OSAS diagnostic criteria: typical sleep snoring, daytime sleepiness, AHI (times/h) value ≥ 5. The severity of OSAS was classified as mild OSAS: 5≤AHI＜15; moderate OSAS: 15≤AHI＜30; severe OSAS: AHI≥30. Non-normally distributed measurement data were compared by rank sum test; count data were compared by χ² test. Spearman correlation analysis was performed on the correlation between OSAS and CSC.Results The AHI data in the CSC group and the control group were 17.46±3.18 and 15.72±4.48 times/h, respectively; the MOS were (83.48±4.68)% and (87.40±3.82)%, respectively; those diagnosed with OSAS were respectively 36 (72.00%, 36/50) and 13 (26.00%, 13/50) cases. AHI (Z=0.312), MOS (Z=0.145), and OSAS incidence (χ²=21.17) were compared between the two groups of subjects, and the differences were statistically significant (P=0.028, 0.001,＜0.001). The AHI of acute and chronic CSC patients were 15.95±3.02 and 18.47±2.92 times/h; the MOS were (86.10±11.07)% and (81.73±4.58)%, respectively. There were statistically significant differences in AHI (Z=0.134) and MOS (Z=0.112) in patients with different course of disease (P=0.005, 0.001). The results of Spearman correlation analysis showed that OSAS and CSC were positively correlated (r=0.312, P=0.031).Conclusion OSAS may be a risk factor for the onset of CSC.

Citation： Li Luxi, Zhang Peng, Wang Yanhui, Chen Lian, Lei Min, He Ke, Li Xiaoqing, Jiang Zhao. Relationship between obstructive sleep apnea syndrome and central serous chorioretinopathy. Chinese Journal of Ocular Fundus Diseases, 2020, 36(9): 714-717. doi: 10.3760/cma.j.cn511434-20190507-00171 Copy

1.	Lyons MM, Kraemer JF, Dhingra R, et al. Screening for obstructive sleep apnea in commercial drivers using EKG-derived respiratory power index[J]. J Clin Sleep Med, 2019, 15(1): 23-32. DOI: 10.5664/jcsm.7562.
2.	Huang X, Tang S, Lyu X, et al. Structural and functional brain alterations in obstructive sleep apnea: a multimodal meta-analysis[J]. Sleep Med, 2019, 54: 195-204. DOI: 10.1016/j.sleep.2018.09.025.
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6.	何权瀛, 陈宝元. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版)[J]. 中国呼吸与危重监护杂志, 2015, 14(7): 398-405. DOI: 10.3760/cma.j.issn.1671-7368.2015.07.007.He QY, Chen BY. Guidelines for diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (basic edition)[J]. Chin J Respir Crit Care Med, 2015, 14(7): 398-405. DOI: 10.3760/cma.j.issn.1671-7368.2015.07.007.
7.	Elias A, Gopalakrishnan M, Nair D, et al. A ten year study of central serous chorioretinopathy: recurrence rate and factors affecting recurrence[J]. WJORV, 2011, 1(2): 69-74. DOI: 10.5005/jp-journals-10020-1017.
8.	Zhang P, Wang HY, Zhang ZF, et al. Fundus autofluorescence in central serous chorioretinopathy: association with spectral-domain optical coherence tomography and fluorescein angiography[J]. Int J Ophthalmol, 2015, 8(5): 1003-1007. DOI: 10.3980/j.issn.2222-3959.2015.05.27.
9.	张鹏, 王海燕, 张自峰, 等. 急性中心性浆液性脉络膜视网膜病变两种不同波长自身荧光和频域光相干断层扫描图像特征观察[J]. 中华眼底病杂志, 2015, 31(3): 240-243. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.007.Zhang P, Wang HY, Zhang ZF, et al. Observation on imaging features of two types of fundus autofluorescence and spectral-domain optical coherence tomography in acute central serous chorioretinopathy[J]. Chin J Ocul Fundus Dis, 2015, 31(3): 240-243. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.007.
10.	Chen SN, Chen YC, Lian I. Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study[J]. Br J Ophthalmol, 2014, 98(1): 110-114. DOI: 10.1136/bjophthalmol-2013-303945.
11.	Uhlig BL, Hagen K, Engstrøm M, et al. The relationship between obstructive sleep apnea and insomnia: a population-based cross-sectional polysomnographic study[J]. Sleep Med, 2018, 54: 126-133. DOI: 10.1186/s1019401808542.
12.	Khayi H, Pepin JL, Geiser MH, et al. Choroidal blood flow regulation after posture change or isometric exercise in men with obstructive sleep apnea syndrome[J]. Invest Ophthalmol Vis Sci, 2011, 52(13): 9489-9496. DOI: 10.1167/iovs.11-7936.
13.	王静波, 刘金伟, 张琳, 等. 阻塞性睡眠呼吸暂停低通气综合征患者脉络膜厚度的变化[J]. 国际眼科杂志, 2018, 18(3): 482-485. DOI: 10.3980/j.issn.1672-5123.2018.3.18.Wang JB, Liu JW, Zhang L, et al. Alteration of choroidal thickness in patients with obstructive sleep apnea hyponea syndrome[J]. Int Eye Sci, 2018, 18(3): 482-485. DOI: 10.3980/j.issn.1672-5123.2018.3.18.

1. Lyons MM, Kraemer JF, Dhingra R, et al. Screening for obstructive sleep apnea in commercial drivers using EKG-derived respiratory power index[J]. J Clin Sleep Med, 2019, 15(1): 23-32. DOI: 10.5664/jcsm.7562.
2. Huang X, Tang S, Lyu X, et al. Structural and functional brain alterations in obstructive sleep apnea: a multimodal meta-analysis[J]. Sleep Med, 2019, 54: 195-204. DOI: 10.1016/j.sleep.2018.09.025.
3. Liu B, Deng T, Zhang J. Risk factors for central serous chorioretinopathy: a systematic review and meta-analysis[J]. Retina, 2016, 36(1): 9-19. DOI: 10.1097/iae.0000000000000837.
4. Hanumunthadu D, Ruiz-Medrano J, Dumpala S, et al. Comparison of choroidal vessel thickness in children and adult eyes by enhanced-depth imaging optical coherence tomography imaging[J]. Int J Ophthalmol, 2018, 11(4): 681-686. DOI: 10.18240/ijo.2018.04.24.
5. Hanumunthadu D, Tan ACS, Singh SR, et al. Management of chronic central serous chorioretinopathy[J]. Indian J Ophthalmol, 2018, 66(12): 1704-1714. DOI: 10.4103/ijo.IJO141218.
6. 何权瀛, 陈宝元. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版)[J]. 中国呼吸与危重监护杂志, 2015, 14(7): 398-405. DOI: 10.3760/cma.j.issn.1671-7368.2015.07.007.He QY, Chen BY. Guidelines for diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (basic edition)[J]. Chin J Respir Crit Care Med, 2015, 14(7): 398-405. DOI: 10.3760/cma.j.issn.1671-7368.2015.07.007.
7. Elias A, Gopalakrishnan M, Nair D, et al. A ten year study of central serous chorioretinopathy: recurrence rate and factors affecting recurrence[J]. WJORV, 2011, 1(2): 69-74. DOI: 10.5005/jp-journals-10020-1017.
8. Zhang P, Wang HY, Zhang ZF, et al. Fundus autofluorescence in central serous chorioretinopathy: association with spectral-domain optical coherence tomography and fluorescein angiography[J]. Int J Ophthalmol, 2015, 8(5): 1003-1007. DOI: 10.3980/j.issn.2222-3959.2015.05.27.
9. 张鹏, 王海燕, 张自峰, 等. 急性中心性浆液性脉络膜视网膜病变两种不同波长自身荧光和频域光相干断层扫描图像特征观察[J]. 中华眼底病杂志, 2015, 31(3): 240-243. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.007.Zhang P, Wang HY, Zhang ZF, et al. Observation on imaging features of two types of fundus autofluorescence and spectral-domain optical coherence tomography in acute central serous chorioretinopathy[J]. Chin J Ocul Fundus Dis, 2015, 31(3): 240-243. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.007.
10. Chen SN, Chen YC, Lian I. Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study[J]. Br J Ophthalmol, 2014, 98(1): 110-114. DOI: 10.1136/bjophthalmol-2013-303945.
11. Uhlig BL, Hagen K, Engstrøm M, et al. The relationship between obstructive sleep apnea and insomnia: a population-based cross-sectional polysomnographic study[J]. Sleep Med, 2018, 54: 126-133. DOI: 10.1186/s1019401808542.
12. Khayi H, Pepin JL, Geiser MH, et al. Choroidal blood flow regulation after posture change or isometric exercise in men with obstructive sleep apnea syndrome[J]. Invest Ophthalmol Vis Sci, 2011, 52(13): 9489-9496. DOI: 10.1167/iovs.11-7936.
13. 王静波, 刘金伟, 张琳, 等. 阻塞性睡眠呼吸暂停低通气综合征患者脉络膜厚度的变化[J]. 国际眼科杂志, 2018, 18(3): 482-485. DOI: 10.3980/j.issn.1672-5123.2018.3.18.Wang JB, Liu JW, Zhang L, et al. Alteration of choroidal thickness in patients with obstructive sleep apnea hyponea syndrome[J]. Int Eye Sci, 2018, 18(3): 482-485. DOI: 10.3980/j.issn.1672-5123.2018.3.18.

Chinese Journal of Ocular Fundus Diseases

Relationship between obstructive sleep apnea syndrome and central serous chorioretinopathy

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