Diurnal changes of retinal microvascular circulation and RNFL thickness measured by optical coherence tomography angiography in patients with obstructive sleep apnea-hypopnea

• Authors: Yi Cai, Peking University People’s Hospital; Wen-Bo Liu, Peking University People’s Hospital; Miao Zhou, Peking University People’s Hospital; Yu-Tong Jin, Emory University; Guo-Sheng Sun, Peking University People’s Hospital; Long Zhao, Peking University People’s Hospital; Fang Han, Peking University People’s Hospital; Jin-Feng Qu, Peking University People’s Hospital; Xuan Shi, Peking University People’s Hospital; Ming-Wei Zhao, Peking University People’s Hospital
• Journal Title: FRONTIERS IN ENDOCRINOLOGY
• Volume: Volume 13
• Publisher: FRONTIERS MEDIA SA | 2022-08-09, Pages 947586-947586
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3389/fendo.2022.947586
• Subjects: Health Sciences, Opthamology; Biology, Biostatistics
• Keywords: Science & Technology; Life Sciences & Biomedicine; Endocrinology & Metabolism; optical coherence tomography angiography; obstructive sleep apnea-hypopnea; retinal nerve fiber layer; deep capillary plexus; radial peripapillary capillary; vessel density; ocular diurnal changes; NERVE-FIBER LAYER; CHOROIDAL THICKNESS; VESSEL DENSITY; ASSOCIATION; OSA

Abstract

Purpose: To evaluate capillaries perfusion and retinal nerve fiber layer (RNFL) thickness diurnal changes of macular/optic disc regions among participants with or without obstructive sleep apnea-hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA). Methods: In this study, we enrolled a cohort of 35 participants including 14 patients with mild-to-moderate OSA, 12 patients with severe OSA, and 9 healthy individuals. All participants had Berlin questionnaire filled. At 20:00 and 6:30, right before and after the polysomnography examination, a comprehensive ocular examination was conducted. The systemic and ocular clinical characteristics were collected, and OCTA scans were performed repeatedly. Blood flow and RNFL thickness parameters were then exported using built-in software and analyzed accordingly. Results: After sleep, the overall vessel density (VD) variables, especially macular and choriocapillaris VDs, were relatively comparative and stable. One exception was the RPC vessel density at the inside-disc region with a decreasing trend in the mild-to-moderate group (p=0.023). RNFL changes before and after sleep in the nasal-inferior and peripapillary region were statistically significant (p=0.003; p=0.043) among three groups. And multiple testing correction verified the significant difference in diurnal changes between the mild-to-moderate group and the control group in pairwise comparisons (p=0.006; p=0.02). Conclusions: The changes of imperceptible blood flow and RNFL thickness overnight around optic disc areas could be observed in OSA patients. Despite physiological fluctuations, aberrant diurnal changes might be useful for identifying a decrease in micro-environmental stability associated with the development of various ocular diseases such as glaucoma. Other VD variables, especially macular and choriocapillaris VDs, are relatively stable in eyes of patients having OSA with different severity.