Abstract
Purpose :
This prospective, observational case series of patients with obstructive sleep apnea (OSA) characterized qualitative and quantitative anatomic microvascular changes in the retina and choroid of OSA patients using Optical Coherence Tomography Angiography (OCTA).
Methods :
20 eyes of 10 patients with OSA and 20 eyes from 10 aged matched controls underwent 3x3mm and 6x6mm macular scans using Cirrus HD-OCT 5000 Angioplex (Carl Zeiss, Meditech CA. USA). The scans were captured at ~840nm wavelength and 68,000 A-scans/second and the split-spectrum amplitude-decorrelation angiography algorithm was utilized. Presence and severity of OSA was determined by limited channel ambulatory monitoring including Apnea-Hypopnea Index (AHI), lowest oxygen saturation, and total time with oxygen saturation level lower than 90%. Data collected included areas of impaired capillary perfusion on OCTA, and qualitative and quantitative grading for peripapillary and macular retinal capillary and choriocapillaris perfusion by an unbiased novel automatic original software which determined which area had OCTA changes consistent with low flow.
Results :
OCTA peripapillary and macular retinal and choroidal microvasculature defects were identified and were characterized for OSA patients yielding to the development of a novel OCTA based scale which correlated the severity of these microvascular changes with the severity of OSA.
Conclusions :
OCTA macular and peripapillary perfusion defects indicated apparent anatomic correlations with the severity of OSA. Larger scale studies will be needed to determine the role of OCTA in the ocular and systemic management of OSA patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.