Ocular findings and parameters in patients with sleep apnea syndrome

Purpose: The aim of this study is to detect ocular findings in patients with obstructive sleep apnea syndrome (OSAS) and to determine the susceptibility to dry eye, glaucoma and floppy eyelid syndrome with ophthalmologic examinations. Methods: For this study, 31 patients were diagnosed with OSAS according to apnea/hypopnea index in the results of polysomnography and prediagnosis of sleep apnea by Çukurova University Neurology Department Sleep Laboratory and 30 patients who were below the apnea/hypopnea index of 5 and who had obstructive sleep apnea were excluded by randomly selected. Ophthalmologic examination, central corneal thickness, retinal nerve fiber analysis, visual field evaluation, optical cohorence tomography, schirmer test, tear breakage time, meibography, ocular surface disease index scoring, eyelid laxity measurements were performed in each patients. Results: 31 patients were included in the study group and 30 patients in the control group. There was no statistically significant difference between the two groups in terms of gender and age. No statistically significant difference was found in central corneal thickness and retina nerve fiber thickness analysis for glaucoma diagnosis. However, the visual field defect was found to be significantly higher in the study group with respect to pattern standard deviation and mean deviation in visual field examination. Mean intraocular pressure was lower in the control group than in the study group, but glaucoma was not interpreted favorably because the mean intraocular pressures were within normal values in both groups. The choroidal thickness in the macular images with optical cohorence tomography was found to be thinner in the study group than in the control group. The Schirmer and tear break time tests for dry eye diagnosis were found to be significantly lower, the meibomian gland loss percentage in meibography and the OSDI score were significantly higher in the study group than in the control group. The rate of floppy eyelid syndrome according to the cover laxity measurements was found to be higher in the OSAS group compared with control group. Conclusions: Although pathophysiology can not be exactly explained in patients with OSAS diagnosis, hypoxia and resulting cascades can lead to dry eyes, loose eyelid syndrome, choroidal thinning. Early diagnosis and treatment of these diseases, which affect the quality of life and visual prognosis in the elderly, are important. There is a need for longitudinal studies to understand the pathophysiology of these diseases that are increasingly common in OSAS and to develop treatment-oriented therapies.