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Amir Mohsenin, Vahid Mohsenin, Ron Adelman; Increased Retinal Vascular Tortuosity in Obstructive Sleep Apnea. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4635.
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Obstructive sleep apnea (OSA) is a highly prevalent disorder with significant vascular morbidity and mortality. Affected patients are subjected to intermittent hypoxemia, hypercapnia, arterial blood pressure surges and increased intracranial pressure during sleep. We sought to examine the effects of OSA on retinal vasculature tortuosity.
A pilot retrospective chart review was conducted identifying patients with and without OSA who had undergone fundus photography. 7 control subjects and 9 subjects with OSA were analyzed. Measurements were taken of the superior and inferior temporal retinal artery and vein starting at the optic disc rim to the crossing point of 2 circles centered on the optic disc with diameters of 5 disc diameters (DD) and 10DD. Retinal vascular tortuosity (tau) was assessed by calculating the arc length/chord length of each vessel segment as per previously published methods.
Patients with OSA have significant increases in arterial and venous tortuosity when measured at the 10DD length. At 5DD, there was no statistically sig difference in arterial tortuosity between the two groups. Venular tortuosity was significantly increased at the 5DD mark in patients with OSA.
These findings demonstrate an association between obstructive sleep apnea and increased retinal vessel tortuosity. A larger study will be necessary to examine the prevalence and significance of this vascular abnormality in OSA.
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