Optical Coherence Tomography Angiography of Optic Disc in patients with Obstructive Sleep Apnea Sindrome

Abstract

Purpose : Several studies have demonstrated that patients with Obstructive Sleep Apnea Sindrome (OSAS) are a glaucoma risk category. OSAS leads to severe hypoxemia and consequent increases in vascular resistance, which may compromise optic nerve head and peripapillary perfusion. Purpose of the study was to investigate optic nerve head and peripapillary retina perfusion in patients affected by OSAS using Optical Coherence Tomography Angiography (OCTA)

Methods : Fourteen eyes with OSAS and 14 healthy subjects were included in the study. Each subject underwent a complete ophthalmological evaluation including visual field test (VF) (Humphrey Field Analyzer II Carl Zeiss Meditec, Inc), circumpapillary retinal nerve fiber layer thickness (cpRNFL) using HRA + OCT Spectralis (SD-OCT, Heidelberg Engineering, Heidelberg, Germany). OCTA was performed acquiring a 3x3 mm volume centered on the disk using the Angiovue OCTA (RTVue-XR; Optovue, Inc). Microvascular densities were studied at the level of the radial peripapillary complex (RPC) and nerve head (NH) segmentation (which included lamina cribrosa) analyzing differences among sectors

Results : Age, global and sectoral RNFL thicknesses, VF mean deviation (MD) and pattern standard deviation (PSD) and intra ocular pressure (IOP) did not differ between OSAS patients and healthy subjects. In OSAS RPC segmentation vessel densities for wild image, inside disc and peripapillary area were respectively 59.27 (SD +/- 1.839), 45.92 (SD +/- 8.685), 67.18 (SD +/- 2.534) whereas in healthy subjects they were 60.65 (SD +/- 2.266), 49.74 (SD +/- 8.111), 67.34 (SD +/- 2.055). NH segmentation vessel densities for wild image, inside disc and peripapillary were 60.94 (SD +/- 2.259), 56.88 (SD +/- 3.298), 64.60 (SD +/- 2.409) in OSAS patients and 62.22 (SD +/- 1.469), 57.32 (SD +/- 2.048), 65.76 (SD +/- 1.300) in healthy subjects. None of the previous results showed statistical significancy

Conclusions : Our results suggest that quantitative OCTA may be useful in OSAS patients to detect optic nerve head and peripapillary vascular density. Further replication studies with a larger sample size are necessary to determine whether OSAS is associated with a significant reduction in optic disc and peripapillary retina perfusion

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.