摘要
目的:探讨合并阻塞性睡眠呼吸暂停症(Obstructive Sleep Apnea,OSA)对非动脉炎性前部缺血性视神经病变(Non Arteritis Anterior Ischemic Optic Neuropathy,NAION)的视网膜神经纤维层厚度的影响。方法:回顾性分析2018年1月至2019年12月解放军总医院第一医学中心眼科就诊的138例NAION患者的光学相干断层扫描(Optical Coherence Tomography,OCT)和便携式睡眠呼吸监测结果。选择患者的视网膜神经纤维层厚度(Retinal Nerve Fiber Layer,RNFL)测量结果和睡眠呼吸监测相关指标。结果:在诊断NAION的患者中,OSA的患病率达到69.6%。按照OSA严重程度划分,中度OSA患者和重度OSA患者的左上侧RNFL差异有统计学意义(P=0.038,P<0.05);按照低氧程度划分,左眼上侧(P=0.006,P<0.05)、鼻侧的RNFL厚度在轻度缺氧和中度缺氧OSA患者组别之间差异有统计学意义(P=0.012,P<0.05);左眼的上侧(P=0.022,P<0.05)、鼻侧(P=0.047,P<0.05)在中度和重度缺氧OSA患者组间差异有统计学意义;左眼下侧的RNFL在中度和重度缺氧OSA患者组间差异有统计学意义(P=0.026,P<0.05);右眼的平均RNFL在血氧正常组与重度缺氧组间差异有统计学意义(P=0.022,P<0.05)。相关性分析未发现REI指数和RNFL、ODI指数和RNFL有显著相关性。结论:合并OSA的NAION患者的视网膜神经纤维层厚度明显低于非合并OSA的NAION患者。患者的最低血氧饱和度越低,视网膜神经纤维层厚度也越薄,建议合并NAION患者均进行睡眠监测以筛查病因。
Objective:To investigate the effect of OSA on the thickness of RNFL in NAION patients.Methods:The results of OCT and portable sleep apnea monitoring were analyzed retrospectively in 138 NAION patients from January 2018 to December 2019.After excluding other causes that may affect RNFL thickness,130 left eyes and 132 right eyes were included.The parameters of RNFL measurement and sleep respiration monitoring were selected,and SPSS 25.0 software was used for statistical analysis.Results:The prevalence of OSA in NAION patients was 69.6%.According to the severity of OSA,there were significant differences in the thickness of RNFL between patients with moderate and severe OSA group(P=0.038,P<0.05)in upper left eyes;According to the severity of hypoxia,superior(P=0.006,P<0.05)and nasal RNFL(P=0.012,P<0.05)thickness of left eye were significantly different between mild and moderate hypoxia group;Superior(P=0.022,P<0.05)and nasal(P=0.047,P<0.05)RNFL thickness of left eyes were also of statistical difference between moderate and severe hypoxia group;Inferior RNFL thickness of left eyes were different between moderate and severe hypoxia group(P=0.026,P<0.05);The average RNFL thickness in the right eye was statistically different between normoxia group and severe hypoxia group(P=0.022,P<0.05).There was no significant correlation between respiratory event index(REI)and RNFL thickness,so as Oxygen desaturation index(ODI)and RNFL thickness.Conclusion:The thickness of RNFL in patients with NAION was significantly lower than that in patients without OSA.The lower the minimum oxygen saturation,the thinner the thickness of the retinal nerve fiber layer.It is suggested that patients with NAION should be monitored for sleep to screen the cause of the disease.
作者
陈一冰
孙明明
王炜芳
杨青华
解立新
CHEN Yibing;SUN Mingming;WANG Weifang;YANG Qinghua;XIE Lixin(1 Department of Respiratory and Critical Care Medicine,the First Medical Center of PLA General Hospital,Beijing 100853,China;Ophthalmology Department,the First Medical Center of PLA General Hospital,Beijing 100853,China)
出处
《世界睡眠医学杂志》
2020年第9期1498-1501,共4页
World Journal of Sleep Medicine
