[Application of optical coherence tomography angiography in evaluation of retinal microvascular changes in patients with obstructive sleep apnea syndrome].

Objective: To assess the changes of retinal microvasculature in patients with obstructive sleep apnea syndrome (OSAS) evaluated by optical coherence tomography (OCTA). Methods: Adult OSAS patients who visited Beijing Tongren Hospital from Jan 2016 to Apr 2016 and complained of snoring were included in this study. The patients' general information, results of polysomnography, and OCTA parameters were collected. Patients were divided into three groups according to their apnea hypopnea index (AHI) results: Mild-moderate group, AHI≤30/h; Severe group, 30/h60/h, and clinical characteristics, polysomnography and OCTA parameters among the three groups were compared. Results: A total of 27 patients were included in this study with 21 males (77.8%) and 6 females (22.2%). Mean age was (41.7±10.0) years, and the mean body mass index was (27.9±4.5) kg/m(2;) Neck circumference was 31-48 cm, mean (39.8±4.3) cm; 8 patients (29.6%) suffered from hypertension that could be controlled; Epworth sleepiness scale scored 1-18 points and mean (8.5±4.4) scores; AHI ranged between 5.5 and 92.1/h with a mean of (46.4±28.6)/h. There were 9 (33.3%), 7 (25.9%), and 11 (40.7%) patients in mild-moderate group, severe group, and extremely severe group, respectively. Compared with severe group, the optic nerve head and radial peripapillary capillaries (RPC) peripapillary vascular density in extremely severe group were significantly decreased (62.4%±1.9% vs 60.3%±1.9%, P=0.041; 64.7%±1.7% vs 62.2%±2.3%, P=0.036). Conclusions: OCTA has rapid, safe, and objective characteristics in assessing the retinal microvascular changes in OSAS patients. Retinal microvascular damage in patients with OSAS is associated with the disease severity. Reduction of retinal microvascular density in patients with OSAS may be associated with intermittent hypoxia.目的： 应用光学相干体层摄影血管成像技术(OCTA)评估阻塞性睡眠呼吸暂停综合征(OSAS)患者的视网膜微血管改变。 方法： 对2016年1—4月以睡眠打鼾就诊于北京同仁医院并诊断为OSAS的成年患者，完成人体学特征采集、整夜多导睡眠图(PSG)监测，同时采用OCTA对视网膜微血管进行定量测量。根据呼吸暂停低通气指数(AHI)将患者分为：轻中度组(AHI≤30次/h)，重度组(30次/h60次/h)，比较各组间视网膜微血管测量结果及其与临床特征、PSG指标的相关性。 结果： 入选27例患者中男21例(77.8%)，女6例(22.2%)；年龄25～65岁，平均(41.7±10.0)岁；体质指数18.5～37.2 kg/m(2)，平均(27.9±4.5)kg/m(2)；颈围31～48 cm，平均(39.8±4.3)cm；可以控制的高血压患者8例(29.6%)；Epworth嗜睡量表评分1～18分，平均(8.5±4.4)分；AHI 5.5～92.1次/h，平均(46.4±28.6)次/h，其中轻中度组9例(33.3%)，重度组7例(25.9%)，极重度组11例(40.7%)。与重度组相比，极重度组视乳头层盘周区血管密度值(62.4%±1.9%比60.3%±1.9%，P＝0.041)、放射状盘周毛细血管层盘周区血管密度值(64.7%±1.7%比62.2%±2.3%，P＝0.036)均显著降低。 结论： OCTA在评估OSAS患者视网膜微血管改变方面具有快速、安全、客观的特点；患者视网膜微血管损伤与其疾病严重程度相关，视网膜微血管密度降低可能与间断性缺氧有关。.