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Amir Mohsenin, Ron A. Adelman; Retinal Manifestations of Obstructive Sleep Apnea. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5206.
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Obstructive sleep apnea is a highly prevalent disorder with high vascular morbidity and mortality. These patients are subjected to intermittent hypoxemia, hypercapnia, arterial blood pressure surges and increased intracranial pressure during sleep. We sought to examine the effects of sleep apnea on the retina.
Consecutive patients with obstructive sleep apnea on treatment underwent detailed eye examination which included full retinal imaging. Retinal vessel tortuosity was graded in a masked manner as being none, mild, moderate, and severe according to a previously published method.
Eight patients (8 men) with mean age (SD) 5111years and BMI 36.65.8 kg/m2 were studied. The apnea-hypopnea index was 5033 events/hr with mean asleep oxygen saturation of 90.8%1.7 and nadir oxygen saturation of 73.3%11. 75% of subjects had arterial hypertension and 25% were diabetic. 2 patients have glaucoma and 1 has ocular hypertension. The average logMAR visual acuity was 0.140.18 (20/28) with a range between 20/20-20/80. Mean IOP was 194 (range 12-26). Tortuosity in the major retinal vessels was found in 50% of the patients (25% mild, 50% moderate, 25% severe). Macular vessel tortuosity was found in 100% of patients (50% mild, 25% moderate, 25% severe). Macular vessel telangiectasia was found in 50% of patients (50% mild, 50% moderate).
These findings demonstrate an association between retinal vessel tortuosity and obstructive sleep apnea. Vascular changes including tortuosity and telangiectasia were more prominent in the macula. These abnormalities may be related to increased intracranial pressure or abnormal blood gases.
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