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G. Leroux les Jardins, A. Glacet-Bernard, S. Lasry, G. Coscas, G. Soubrane, B. Housset, E. Souied; Sleep Apnea Syndrome and Retinal Vein Occlusion: About a Series of 30 Patients. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3553.
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Obstructive sleep apnea (OSA) is a relatively common disease and has been recently implicated in numerous cardiovascular, neurologic and ophthalmologic diseases. This condition is largely under-recognized and its prevalence in the general population is approximately 2% to 7%. OSA is known to be associated to age, snoring, daytime sleepiness and obesity. This study was designed to evaluate the possible implication of OSA in retinal vein occlusion (RVO).
From the records of 63 consecutive RVO patients, 30 patients were retrospectively selected for OSA screening. The selected patients had to meet at least two of the three following criteria: associated cardiovascular disease, snoring or daytime sleepiness (Epworth scale of 10 or more). They were investigate for OSA using nocturnal polygraphy during an overnight stay at hospital.
23 patients out of the 30 selected patients (76%) were OSA positive. Among these patients, the average apnea-hypopnea index was 21 per hour, OSA was mild (<15/h) in 13 patients, moderate in 5 patients, and severe (>30/h) in 5 patients. The number of apnea or hypopnea per hour was correlated to the body mass index (p=.02), the mean saturation of blood in oxygen (p=.004) and the duration under an oxygen saturation of 90% (p<.0001).
This study demonstrated for the first time a high prevalence of OSA in patients with RVO. This association may explain why a majority of patients discover visual loss upon awakening. Our findings suggest that OSA could be an additional risk factor that play an important role in the pathogenesis of RVO, or that it is at least a frequent associated condition that could play a role of triggering factor. It is too early to assess that OSA treatment could improve visual outcome of RVO, but it seems vital to recognize OSA in RVO for the general health of the patient.
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