Alterations in Parafoveal and Optic Disc Vessel Densities in Patients with Obstructive Sleep Apnea Syndrome

Abstract

Purpose. To analyze the effects of obstructive sleep apnea syndrome (OSAS) on ocular parameters and determine the alterations in macular vasculature by optical coherence tomography-angiography (OCT-A) in patients with different stages of OSAS. Methods. All the participants underwent a full ophthalmological examination. Using the macular OCT-A scans, the retinal peripapillary capillary plexus (RPCP), foveal avascular zone (FAZ), and superficial and deep vessel densities were recorded. Results. A total of 77 patients (154 eyes) with OSAS and 27 control cases (54 eyes) were included in this prospective study. Of the OSAS patients, 27 had mild, 24 had moderate, and 26 had severe disease. The intraocular pressure (IOP) values were significantly higher in the severe OSAS group than the control cases (p=0.001). The average retinal nerve fiber layer (RNFL) thickness and the RNFL thickness of the temporal and inferior quadrants were significantly lower in the severe OSAS group compared with the control cases (p<0.05). There was a significant decrease in the mean RPCP values with a significant increase in the FAZ values of OSAS patients compared with the control group (p=0.001). Both the superficial and deep vascular densities were significantly decreased in OSAS patients, being the lowest in the severe OSAS group. Conclusions. Decreased vascular structures and increased FAZ may also be associated with the disease severity in OSAS and may be the main pathophysiological mechanisms in ocular alterations, which should be investigated in further studies.