Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Chalkiadaki Evangelia
Dissertation committee:
Χρυσάνθη Κουτσανδρέα, Ομότιμη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπουσα
Παναγιώτης Θεοδοσιάδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Παπακωνσταντίνου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Μπρούζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ηλίας Γεωργάλας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κλειώ Χατζηστεφάνου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Δρούτσας, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Οφθαλμικές μεταβολές σε άτομα που πάσχουν από το Σύνδρομο Αποφρακτικών Απνοιών στον Ύπνο
Translated title:
Ocular alterations in patients with Obstructive Sleep Apnea - Hypopnea Syndrome
Summary:
Purpose: To investigate corneal endothelial morphometry and pachymetry in patients newly diagnosed with Obstructive Sleep Apnea – Hypopnea Syndrome (OSAHS) and to determine the correlation between these parameters and OSAHS severity. Our study also aimed to evaluate the effects of Continuous Positive Airway Pressure (CPAP) therapy on central endothelial morphology and corneal thickness.
Methods: Fifty-eight (58) patients recently diagnosed with OSAHS and a paired, age- and gender-matched control group (CG) of 58 healthy individuals were enrolled. A detailed ophthalmologic examination and specular microscopy measurement was performed for all participants. Endothelial cell density (ECD), coefficient of variation of cell area (CV), hexagonal cell appearance ratio (% Hex) and central corneal thickness (CCT) were compared between the groups. The specular microscopy results of the OSAHS group were correlated with the polysomnographic variables of each individual. Τhe OSAHS patients who showed good compliance with CPAP treatment were re-evaluated after the commencement of CPAP therapy and their corneal values were compared with their pre-CPAP values.
Results: ECD and CCT did not significantly differ between the newly diagnosed OSAHS patients and the CG (p = 0,3 , p = 0,1 respectively). CV was significantly higher (p = 0,002), whilst the Hex ratio was significantly lower (p = 0,001) in the OSAHS group. A significant negative correlation was observed between CCT and the REM sleep percentage (p = 0,008). Twenty-seven (27) OSAHS patients were re-examined after 9,56 ± 3,55 months (range: 3-18 months) of good adherence to CPAP treatment. Their CV values, indicating polymegathism, showed a statistically significant decrease (p = 0,04), whereas the Hex ratio, indicating pleomorphism, showed a statistically significant increase (p = 0,008) after the commencement of the treatment.
Conclusions: Greater pleomorphism and polymegathism of the corneal endothelium was observed in patients with OSAHS when compared to healthy subjects. Low percentage of REM sleep, usually found in OSAHS patients, may correlate with an increase in corneal thickness, an indicator of poor corneal oxygenation. However, better oxygenation during sleep resulting from increased CPAP compliance had a significant influence on corneal endothelium, providing an improvement in corneal polymegathism and pleomorphism.
Main subject category:
Health Sciences
Keywords:
Obstructive Sleep Apnea - Hypopnea Syndrome, Corneal endothelium, Polymegathism, Pleomorphism, Continuous positive airway pressure therapy
Number of references:
183
