Halim, Nazihatul Fikriah Abd
(2017)
Evaluation of retinal fibre layer thickness and optic nerve head parameters in obstructive sleep apnoea patients.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder which can be life
threatening characterized by partial (hypopnoeas) and complete pauses (apnoeas) in
breathing lasting at least 10 seconds during sleep. As a result, the blood oxygen
saturation may fall, with resulting in a hypoxia state. OSA has been associated with
ocular conditions such as non-arteritic anterior ischemic optic neuropathy (NAION),
papilloedema, glaucoma and central retinal vein occlusion. Optical Coherent
Tomography (OCT) can measure the retinal nerve fibre layer (RNFL) thickness and
optic nerve head (ONH) parameter changes that can result from the disease.
Objective
The aim of this study was to compare the changes of RNFL thickness and ONH
parameters in patients with OSA and control group. We also analyzed the relationship
between these parameters with the severity of OSA.
Material and methods
A comparative cross-sectional study was conducted in Hospital Universiti Sains
Malaysia involving 54 samples who was diagnosed to have OSA based on overnight
polysomnography (PSG) and 54 control subjects. A complete ocular examination was
performed. RNFL thickness and ONH parameters were measure using the OCT.
Independent t-test, chi square, Exact Fisher test, correlation and regression analysiswere use in the statistical analysis.
Results
There were statistically significant thinning of the RNFL of the OSA group compared
to control. In obstructive sleep apnoea group (OSA), mean of average RNFL thickness
was 93.87μm, SD= 9.17, p=0.0008 (p<0.05) while superior RNFL thickness was
113.59μm, SD=16.29, p= <0.001 (<0.05). The changes in RNFL thickness has fair
significant linear relationship with the severity of the disease particularly involving
superior RNFL with R=0.293, R2= 0.087 r= -0.293 p=0.030 (p<0.05), and nasal
RNFL R=0.292, R2=0.085, r= -0.292 p=0.032 (p<0.05). Optic nerve head parameters
had no significant difference from control and there was no significant direct linear
relationship of all the optic nerve head parameters with the severity of the disease.
However, the RNFL thickness was confounded by dyslipidaemia.
Conclusion
OSA patients have significantly thinner in average and superior RNFL layer compared
to control. There was fair significant direct linear relationship of RNFL thickness with
the severity of the disease.
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