Evaluation of Subclinical Papilledema in Patients with Obstructive Sleep Apnea Syndrome

INTRODUCTION: The aim of this study is to analyze optic nerve head total retinal thickness (TRT) in Obstructive Sleep Apnea Syndrome (OSAS) and demonstrate a possible subclinical papilledema
METHODS: Thirty-six patients with suspected OSAS underwent standard overnight polysomnography and were grouped into mild, moderate and severe. Seventy eyes of thirty six OSAS patients and seventy-two eyes of healthy controls were included. Retinal nerve fiber layer thicknesses (RNLF) and TRT s were measured by optic coherence tomography.
RESULTS: RNFL segment values showed no difference between OSAS and control groups. RNFL superior segment and inferonasal segments of the mild OSAS subgroup were found to be thinner than the moderate and severe OSAS subgroups (p=0.034, p=0.025, respectively). RNFL point values also showed no difference between the two groups. The RNFL inferior point of the mild OSAS subgroup was found to be thinner than the moderate and severe subgroups (p=0.036). OSAS TRTs were thinner than the controls at inferior and temporal points (p=0.005, p=0.033, respectively). The TRT inferior point of the mild OSAS subgroup was found to be thinner than the moderate and severe subgroups (p=0.006). At all points
RNFL values were subtracted from the TRT values and compared. At the temporal point the OSAS group’s TRT-RNFL was thinner than that of the control groups (p=0.029).

DISCUSSION AND CONCLUSION: TRT measurements could not demonstrate a possible subclinical papilledema. Thinning of RNFL thickness and TRT in OSAS patients could be the result of hypoxemia related chronic atrophy.