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J.G. McHenry; Sleep Apnea and Optic Neuropathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):625.
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Purpose: To elucidate the characteristics of patients with sleep apnea associated optic neuropathy. Methods: The records of four consecutive patients who presented to the neuro-ophthalmology clinic at the University of Texas Southwestern with no other causes for their optic neuropathy than sleep apnea were retrospectively reviewed. Results: All patients had headache, snoring, nocturnal wakening,fatigue, loss of vision upon awakening and sequential bilateral involvement. Three had disc swelling while one had segmental pallor. Ages ranged from 43 to 73. Two were middle-aged obese men while two were elderly women of normal body habitus. Visual acuities ranged from 20/20 to counting fingers. Visual field defects included paracentral scotomas, arcuate scotomas and generalized depression. All patients were treated with CPAP. One showed mild improvement in the mean deviation of the Humphrey visual field from -4.07 db to -3.17 db with a decrease in disc swelling on treatment. All indicated an improvement in morning headache and fatigue. Conclusions: Sleep apnea must be considered in the differential diagnosis of ischemic optic neuropathy. Although improvement in visual function can occur on treatment with CPAP, it is unclear whether CPAP decreases progressive visual loss.
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