摘要目的：评估 OSAHS 患者视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度变化。方法收集2014年6~10月于秦皇岛市第一医院初次应用多导睡眠监测仪诊断 OSAHS 患者共30例,选取健康体检患者15例,年龄30~50岁,无视野缺损,进行病例对照研究。应用光学相干断层成像(optical coherence tomography,OCT)测量患者视网膜神经纤维层厚度来评估 OSAHS 的 RNFL情况。结果与正常对照组比较,OSAHS 患者平均视网膜神经纤维层厚度降低,且差异有统计学意义,对照组(121.5±7.9)μm,OSHSA 组(116.3±8.3)μm (P <0.01),同样鼻侧也是降低的, OSAHS (70.4±3.8)μm,对照组(70.7±6.7)μm (P <0.05)。而上侧 OSAHS 组(140.2±8.3)μm,对照组(140.0±9.0)μm (P >0.05),下侧 OSAHS 组(140.5±8.3)μm,对照组(140.3±7.5)μm (P >0.05),颞侧 OSAHS 组(72.5±6.2)μm,对照组(72.2±5.3)μm 差异无统计学意义(P >0.05)。根据呼吸暂停低通气指数(apnea hypopnea index,AHI)将患者分为三组,重度OSAHS 患者较轻度、中度 OSAHS 患者 RNFL 平均值明显降低(P <0.01),而轻度与中度组比较差异无统计学意义(P >0.05)。而三组患者上侧、下侧及颞侧 RNFL 差异无统计学意义。OSAHS 组黄斑厚度(173.3±4.7μm)与对照组比较(173.3±4.6)μm 变化不明显(P >0.05)。OSAHS 组与对照组黄斑体积差异无统计学意义,分别为(6.9±0.3)mm3,(6.8±0.3)mm3(P >0.05)。OSAHS患者 AHI 与 RNFL 呈负相关(r =-0.554,P <0.01)。夜间最低血氧饱和度与 RNFL 平均值成正相关(r =0.510,P <0.01)。结论 OSAHS 患者 RNFL 厚度平均值及鼻侧是降低的,RNFL 厚度与AHI 呈负相关,与夜间最低血氧饱和度呈正相关。

abstractsObjective To assess the peripapillary retinal nerve fiber layer (RNFL) thickness in patients affected by obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods This prospective, observation case-control study consisted of 60eyed of 30 OSAHS patients which diagnosed first from the first hospital of qinhuangdao from June 2014 to October.Results OSAHS patients showed a significant reduction of the average,controls (121.5 ± 7.9)μm,OSHSA (1 1 6.3 ± 8.3)μm (P <0.01) and nasal quadrant.OSAHS(70.4±3.8)μm,controls (70.7±6.7)μm (P <0.05) RNFL thickness.There was no differences in superior,inferior and temporal quadrant RNFL thickness.The average of severe OSAHS patients thinner than mild and moderate (P < 0.01).No differences in macular thickness and volume were observed between OSAHS patients and controls.There was negative correlation between AHI and RNFL thickness (r =-0.554,P <0.01) and positive correlation between the lowest oxygen saturation and RNFL thickness (r = -0.5 10,P < 0.01).Conclusions RNFL thickness of OSAHS patients is reduced.There is negative correlation between AHI and RNFL thickness and positive correlation between the lowest oxygen saturation and RNFL thickness.