Correlation between obstructive sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Luxi ¹ , Wang Yanhui ² , Yuan Jie ² , Jiang Zhao ¹ ,  Zhang Peng 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：

Sleep apnea, obstructive; Optic neuropathy ischemic; Correlation analysis

DOI：

10.3760/cma.j.issn.1005-1015.2019.03.006

Video：

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Objective To determine the correlation between obstructive sleep apnea syndrome (OSAS) and nonarteritic ischemic optic neuropathy (NAION).Methods It was a perspective study. A total of 41 consecutive patients with NAION (NAION group) and 41 age- and sex-matched physical examination subjects (control group) in Xi’an No.3 Hospital from December 2016 to December 2018 were enrolled in this study. The apnea hypopnea index (AHI, the number of sleep apneas per hour) was monitored using a polysomnography for patients in NAION group and control group. At the same time, the blood oxygen saturation was continuously recorded. The OSAS can be diagnosed if the AHI value was ≥5. OSAS severity was graded as mild: 5≤AHI＜15; moderate: 15≤AHI＜30; severe: AHI ≥30. The grading of OSAS severity between two groups was compared by Fisher's exact test. The AHI and minimum blood oxygen saturation were compared between NAION group and control group using the Mann-Whitney U test. Spearman correlation analysis was performed on the correlation between OSAS and NAION.Results Among the patients in the NAION group, 31 patients (75.61%) were diagnosed with OSAS. Among them, 6 patients (14.63%) were mild, 9 patients (21.95%) were moderate, and 16 patients (39.03%) were severe. In the control group, 19 patients (46.34%) were diagnosed with OSAS. Among them, 10 patients (24.39%) were mild, 5 patients (12.20%) were moderate, and 4 patients (9.75%) were severe. The difference of OSAS patients of mild, moderate and severe between two groups were statistically significant (Z=0.235, 0.245, 0.312; P=0.012, 0.014, 0.032). The average AHI of patients in the NAION group was 20.25±7.74, and the mean minimum oxygen saturation at night was (87.38±5.53)%. The average AHI of the control group was 18.67±11.67, and the mean minimum oxygen saturation at night was (85.06+4.25)%. The differences of the mean AHI and mean minimum oxygen saturation between two groups were statistically significant (Z=1.124, 2.317, P=0.003, 0.020). There was a positive correlation between OSAS and NAION (Spearman correlation coefficient=0.229, P=0.030).Conclusion There is a positive correlation between OSAS and NAION.

Citation： Li Luxi, Wang Yanhui, Yuan Jie, Jiang Zhao, Zhang Peng. Correlation between obstructive sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy. Chinese Journal of Ocular Fundus Diseases, 2019, 35(3): 242-245. doi: 10.3760/cma.j.issn.1005-1015.2019.03.006 Copy

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9.	Newman NJ, Scherer R, Langenberg P. Ischemic Optic Neuropathy Decompression Trial Research Group. The fellow eye in NAION: report from the ischemic optic neuropathy decompression trial follow-up study[J]. Am J Ophthalmol, 2002, 134(3): 317-328. DOI: 10.1016/S0002-9394(02)01639-2.
10.	郭继援, 史芳荣, 杜献芳. 颈动脉粥样硬化及同型半胱氨酸与前部缺血性视神经病变的相关性[J]. 国际眼科杂志, 2015, 15(7): 1266-1268. DOI: 10.3980/j.issn.1672-5123.2015.7.44.Guo JY, Shi FR, Du XF. Clinical observation on the association among carotid atherosclerosis, homocysteine and anterior ischmic optic neuropathy[J]. Int Eye Sci, 2015, 15(7): 1266-1268. DOI: 10.3980/j.issn.1672-5123.2015.7.44.
11.	Hayreh SS, Zimmerman MB, Podhajsky P. Nonarteritic anterior ischemic optic neuropathy: role of nocturnal arterial hypotension[J]. Arch Ophthalmol, 1997, 115(7): 942-945. DOI: 10.1016/S0042-6989(97)00032-1.
12.	Hashim SP, Al Mansouri FA, Farouk M. Prevalence of glaucoma in patients with moderate to severe obstructive sleep apnea: ocular morbidity and outcomes in a 3 year follow-up study[J]. Eye (Lond), 2014, 28(11): 1304-1309. DOI: 10.1038/eye.2014.195.
13.	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, 2019, 54: 126-133. DOI: 10.1016/j.sleep.2018.10.026.
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1. Barros AE, Amram AL, Derham AM, et al. Management of ischemic optic neuropathies[J]. Expert Rev Ophthalmol, 2017, 12(2): 99-109. DOI: 10.1080/17469899.2017.1291341.
2. Miller NR, Arnold AC. Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy[J]. Eye (Lond), 2015, 29(1): 65-79. DOI: 10.1038/eye.2014.144.
3. Tesser RA, Niendorf ER, Levin LA. The morphology of an infarct in nonarteritic anterior ischemic optic neuropathy[J]. Ophthalmology, 2003, 110(10): 2031-2035. DOI: 10.1016/S0161-6420(03)00804-2.
4. Morinaga Y, Matsumura K, Kansui Y. Impact of obstructive sleep apnea on blood pressure and cardiovascular risk factors in Japanese men: a cross-sectional study in work-site group[J]. Clin Exp Hypertens, 2018, 40(1): 73-78. DOI: 10.1080/10641963.2017.1324476.
5. Martin SA, Appleton SL, Adams RJ. Erectile dysfunction is independently associated with apnea-hypopnea index and oxygen desaturation index in elderly, but not younger, community-dwelling men[J]. Sleep Health, 2017, 3(4): 250-256. DOI: 10.1016/j.sleh.2017.04.006.
6. Hayreh SS. Ischemic optic neuropathy[J]. Prog Retin Eye Res, 2009, 28(1): 34-62. DOI: 10.3109/01658109409024045.
7. 黄晖明, 王人卫, 李森. 体重指数与体脂率指标评价肥胖: 基于诊断试验的比较研究[J]. 中国运动医学杂志, 2017, 36(3): 218-225. DOI: 10.3969/j.issn.1000-6710.2017.03.006.Huang HM, Wang RW, Li S, et al. Relationship between body mass index and percent body fat in the diagnosis of obesity: based on diagnostic tests[J]. Chin J Sports Med, 2017, 36(3): 218-225. DOI: 10.3969/j.issn.1000-6710.2017.03.006.
8. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版)写作组. 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.Writing Group of Diagnosis and Treatment Guideline of Obstructive Sleep Apnea Hypopnea Syndrome (Basic Edition). Diagnosis and treatment guideline 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.
9. Newman NJ, Scherer R, Langenberg P. Ischemic Optic Neuropathy Decompression Trial Research Group. The fellow eye in NAION: report from the ischemic optic neuropathy decompression trial follow-up study[J]. Am J Ophthalmol, 2002, 134(3): 317-328. DOI: 10.1016/S0002-9394(02)01639-2.
10. 郭继援, 史芳荣, 杜献芳. 颈动脉粥样硬化及同型半胱氨酸与前部缺血性视神经病变的相关性[J]. 国际眼科杂志, 2015, 15(7): 1266-1268. DOI: 10.3980/j.issn.1672-5123.2015.7.44.Guo JY, Shi FR, Du XF. Clinical observation on the association among carotid atherosclerosis, homocysteine and anterior ischmic optic neuropathy[J]. Int Eye Sci, 2015, 15(7): 1266-1268. DOI: 10.3980/j.issn.1672-5123.2015.7.44.
11. Hayreh SS, Zimmerman MB, Podhajsky P. Nonarteritic anterior ischemic optic neuropathy: role of nocturnal arterial hypotension[J]. Arch Ophthalmol, 1997, 115(7): 942-945. DOI: 10.1016/S0042-6989(97)00032-1.
12. Hashim SP, Al Mansouri FA, Farouk M. Prevalence of glaucoma in patients with moderate to severe obstructive sleep apnea: ocular morbidity and outcomes in a 3 year follow-up study[J]. Eye (Lond), 2014, 28(11): 1304-1309. DOI: 10.1038/eye.2014.195.
13. 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, 2019, 54: 126-133. DOI: 10.1016/j.sleep.2018.10.026.
14. Agrawal S, Sharma SK, Sreenivas V. Prevalence of metabolic syndrome in a north Indian hospital-based population with obstructive sleep apnoea[J]. Indian J Med Res, 2011, 134(5): 639-644. DOI: 10.4103/0971-5916.90988.

Chinese Journal of Ocular Fundus Diseases

Correlation between obstructive sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy

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