重度阻塞性睡眠呼吸暂停患者术后视网膜神经纤维层厚度的变化

Variation on the retinal nerve fiber layer thickness for patients with severe obstructive sleep apnea after surgery

目的探讨手术治疗对阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者视网膜神经纤维层(retinal nerve fibre layer,RNFL)厚度的影响。方法本前瞻性、病例对照观察研究包括21例新确诊并拟行低温等离子射频消融术治疗的重度OSAS患者的研究组,及25例年龄、性别相匹配而无OSAS诊断的对照组。采用光学相干断层扫描仪(optical coherence tomography,OCT)分别测量研究组术前和术后1个月RNFL的厚度,同时测量正常对照组的RNFL厚度,利用SPSS软件进行统计分析。结果 (1)研究组术前双眼鼻侧RNFL平均厚度小于对照组(右眼:t=2.334,P=0.024;左眼:t=3.025,P=0.004),差异有统计学意义;(2)与术前比较,研究组术后1个月各象限RNFL均可见变厚,其中,左眼鼻侧RNFL平均厚度变化显著(t=-3.190,P=0.007);(3)研究组术后1个月双眼鼻侧RNFL平均厚度仍小于对照组(右眼:t=2.020,P=0.048;左眼:t=2.072,P=0.044),差异有统计学意义。结论手术治疗可能有助于改善重度OSAS患者视网膜神经纤维缺损。

Objective To explore effect of surgical treatment of patients with severe obstructive sleep apnea syndrome（OSAS） on the retinal nerve fiber layer（RNFL） thickness. Methods This prospective, observational case-control study consisted of newly diagnosed 21 severe OSAS patients who scheduled for temperature-controlled radiofrequency ablation and 25 age-matched controls. Before and one month after surgery, the RNFL thickness was assessed with optical coherence tomography（OCT） for severe OSAS patients as well as health controls. SPSS software was used for statistical analysis. Results（1） The bilateral nasal RNFL thickness was significantly decreased in severe OSAS patients compared with the control group（right eye, t=2.334,P=0.024;left eye, t=3.025,P=0.004）.（2） A month after surgery, each quadrant RNFL thickness increased in severe OSAS patients. Only the nasal quadrant in the left eye of severe OSAS group showed a significance increase compared with preoperative（t=-3.190, P=0.007）.（3） A month after surgery the bilateral nasal RNFL thickness of severe OSAS patients were still less than that of the control group（right eye, t=2.020,P=0.048;left eye, t=2.072,P=0.044）. Conclusions Surgical treatment may help improve retinal nerve fiber layer defect of severe OSAS patients.