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S. Ogawa, T. Nakano, H. Moriwaki, S. Chiba, Y. Ito, H. Matsuda, M. Tatemichi, K. Kitahara; Abnormalities of the Visual Field in Patients With Sleep Apnea Syndrome in Japan. Invest. Ophthalmol. Vis. Sci. 2007;48(13):848.
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© ARVO (1962-2015); The Authors (2016-present)
It has been reported recently that glaucoma frequently complicates sleep apnea syndrome (SAS). However, detailed descriptions on this complication are still scarce in Japan. In the current study, the relationship between visual field defects (detected by FDT perimetry) and SAS was investigated in patients who visited the Outpatient Sleep Clinic of the Jikei University School of Medicine.
The subjects were 182 outpatients who visited the Jikei University Sleep Clinic between September 2001 and May 2003 but had not been treated. To exclude those with other ophthalmic diseases, they were examined for ocular refraction and subjected to slip-lamp examination and funduscopy without pupillary dilation at the ophthalmologic outpatient clinic. The number admitted to our hospital to undergo polysomnography (PSG) was 68 (37.4%). SAS was confirmed in 64 (94.1%) with a rating of Applying Apnea-Hypopnea Index: AHI > 5. These 64 were composed of 58 men and 6 women (mean age, 48.9 years; range, 28-71). The severity of SAS was: mild(AHI 5-15), 14 (21.9%); intermediate(15-30), 13 (20.3%); and severe(>30), 37 (57.8%). The mean body mass index (BMI) was 26.3 ± 4.42 SD. Complications included hypertension 14 and hyperlipidemia 10, both currently being treated. Three were being treated for diabetes mellitus but because they were free of visual field defects, they were included in the current study. The aforementioned 64 patients were subjected bilaterally to C-20-1 screening programs by employing frequency doubling technology (FDT) perimetry. When visual field defects were noted, the reproducibility of the test results were confirmed; and only if defects were found at the same sites the patients were labeled as having abnormalities in the FDT field.Next, the percentage for the development of FDT visual defects was examined. For statistical evaluation, an analysis of covariance was used to observe the correlations between each parameter of PSG and visual defects captured by FDT. A significant correlation was recognized with p < 0.05.
Of the 64 patients with SAS, FDT visual field defects were recognized in 9 (14.1%); but no correlation with AHI was noted (p = 0.615).
The percentage developing FDT visual field defects is high among patients with SAS, suggesting a possible correlation with glaucoma. Further studies are needed on this subject.
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