To investigate the prevalence of sleep-disordered breathing (SDB) in retinal vein occlusion (RVO) patients.
Forty RVO patients who had undergone either vitreous surgery or anti-coagulation therapy were included in this study. Pulse oximetry was conducted during the night and 4% oxygen desaturation index (4% ODI times/hour) and mean SpO2 (%) were calculated. If 4% ODI > or = 5, SDB was diagnosed. The results were compared between branch retinal vein occlusion (BRVO), and central retinal vein occlusion (CRVO). In addition, simple linear regression analyses were conducted to investigate whether 4% ODI related to systemic factors for RVO patients, i.e., incidences of hypertension and diabetes and body mass index(BMI kg/m2).
Forty two percent of the men, 33% of the women and 37% of all the RVO patients were diagnosed as having SDB. The prevalence of SDB and 4% ODI, and the mean SpO2 were not significantly different between the BRVO and CRVO cases. The incidences of diabetes tended to correlate to the 4% ODI, however, neither proved significant. The BMI had a statistic correlation with the 4% ODI.
The results of our study suggested that RVO cases have a high frequency of SDB. We believe that at the time of ophthalmic medical examinations or during the treatment of RVO, ophthalmologists should be aware of the possibility of SDB.
"Until recently, OSAS was not associated with RVO and few studies on this issue have been published [3, 4, 5, 6]. In addition, with the exception of a cohort study by Chou et al. , well-designed epidemiological studies investigating whether RVO is more frequent in OSAS patients are lacking. "
[Show abstract][Hide abstract] ABSTRACT: Purpose
To describe a case of bilateral and simultaneous central retinal vein occlusion (RVO) in a young patient diagnosed with obstructive sleep apnea syndrome (OSAS).
A 38-year-old man with morbid obesity and daytime sleepiness presented with a history of bilateral vision loss. His visual acuity (VA) was hand movements, and fundus examination (FE) revealed bilateral central RVO. General medical examination revealed untreated hypertension and type II respiratory failure. Laboratory tests for thrombophilia showed increased hematocrit (59%) and high levels of fibrinogen and C-reactive protein. Other causes of congenital and acquired hypercoagulability were ruled out. Pathologic polysomnography led to the diagnosis of OSAS. The patient was treated with antihypertensive drugs and continuous positive air pressure. In addition, he received intravitreal ranibizumab. At 10 months after presentation, his VA was no light perception in the right eye and hand movements in the left eye. FE revealed bilateral retinal and optic nerve atrophy, and the occurrence of a nonarteritic anterior ischemic neuropathy in the right eye was considered.
Case Reports in Ophthalmology 05/2014; 5(2):150-6. DOI:10.1159/000363132
[Show abstract][Hide abstract] ABSTRACT: Obstructive sleep apnea (OSA) is a serious disorder characterized with repeated episodes of upper airway obstruction during sleep, resulting in nocturnal hypoxemia and hypercapnia which leads to many systemic and also ocular complications. Various eye disorders reported to be associated with OSA. Floppy eyelid syndrome (FES), cornea disorders, glaucoma, non-arteritic anterior ischemic optic neuropathy, papilledema, central serous chorioretinopathy, and retinal vein occlusion are some of these disorders. (RVO). This review aims to take the attention of the ophthalmologists on the possibility of ocular disorders that can be accompanied by sleeping disorders. Floppy eyelid syndrome Mostly seen in overweight, middle aged males with the complaint of foreign body sensation, burning, tearing, and redness; FES is characterized with the clinical findings of flaccid and easily everted upper lids, occurring spontaneously or with minimal traction, and chronic papillary conjunctivitis of the upper palpebral conjunctiva. Tarsal plaque biopsies of the patients with FES revealed the histopathological features as an increase in the elastolytic metalloproteinase enzymes and a subsequent decrease in the elastin fibers of the tissue [6,7]. In the literature the prevalence of FES in the OSA population has been reported to vary from 2% to 32% [8,9]. OSA is known to be seen mostly in overweight patients, so there is not a clear distinction regarding the etiology concerning whether FES and OSA is related directly or FES is mainly related to obesity. The prevalence of obesity in OSA has ranged from 60% to 70% [10,11], while the prevalence of obesity in FES patients has ranged from 43% to 92% [12,13]. In their review of patients with lax eyelid syndrome, Fowler and Dutton  stated that there was not a significant difference regarding the prevalence of OSA between patients who had obesity and FES and who had obesity but did not have FES. They also found that patients with OSA tended to have the prevalence of obesity significantly higher than those without OSA (76% vs. 20%). So they concluded that increased OSA prevalence among patients with FES was possibly associated with the concomitant obesity. On the contrary of the findings of this study, Ezra et al.  found a strong relationship between OSA and FES independent of weight. They explained that the possible mechanism might have been the changes in central nervous system arousability in OSA. Another possible explanation for the underlying mechanism of the association between OSA and FES is believed to be the increased venous pressure caused by right heart failure and apnea in patients with OSA . Regarding the ocular surface findings along with FES, Acar et al. revealed low levels of Schirmer I values and tear break up times, and an increase in corneal staining and ocular surface disease index scores
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