Obstructive Sleep Apnea is Related with the Risk of Retinal Vein Occlusion

Abstract

Wencui Wan,1,* Zhen Wu,2,* Jia Lu,2,* Weiwei Wan,1 Jing Gao,3 Hongxia Su,4 Wei Zhu5 1Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2Department of Ear, Nose, and Throat, Changshu No. 2 People’s Hospital, Changshu, People’s Republic of China; 3Department of Ophthalmology, First Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, People’s Republic of China; 4Department of Rhinology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 5Department of Ophthalmology, Changshu No. 2 People’s Hospital, Changshu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongxia SuDepartment of Rhinology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of ChinaTel [phone]Email [email protected] ZhuDepartment of Ophthalmology, Changshu No. 2 People’s Hospital, No. 99, Xiannan Street, Changshu, Jiangsu, 215000, People’s Republic of ChinaTel [phone]Email [email protected]: Retinal vein occlusion (RVO) was a vision-threatening retinal vascular disorder, however, the relationship between obstructive sleep apnea (OSA) and RVO risk remained unclear.Methods: A total of 45 RVO cases and 45 controls between April 2018 and April 2020 were included. All the participants underwent full-night polysomnography (PSG) and thus detected the severity of OSA. Besides, the relationship between the apnea–hypopnea index (AHI) and oxidative and inflammatory biomarkers, including 8-hydroxy-2 deoxyguanosine (8-OHdG), C-reactive protein (CRP), interleukin 1 beta (IL1β), interleukin 6 (IL6) and tumor necrosis factor alpha (TNFα) were detected. The incidences of macular edema (ME) and neovascular glaucoma (NVG) were detected in a three-months follow-up.Results: In this case–control study, it was found that OSA incidence was increased in the RVO cases comparing with the cataract controls. Advanced analyses about the RVO subtypes demonstrated that incidence of OSA was higher in the central RVO (CRVO) cases comparing with branch RVO (BRVO) cases. Plasma samples from OSA cases demonstrated relatively higher concentrations of oxidative stress parameters and inflammatory biomarkers, including 8-OHdG, CRP, IL1β, and IL6, in the RVO cases. Significant linear correlations between AHI and oxidative/inflammatory biomarkers were detected, and advanced analyses on the OSA subtypes demonstrated that these biomarkers were significantly higher in cases with later stages of OSA. In a three months follow-up, an impaired visual activity improvement rate and increased ME incidence in the OSA group among all the RVO cases were detected.Conclusion: OSA was related with an increased incidence of RVO. Besides, OSA would lead to increased oxidative and inflammatory biomarkers concentrations in the RVO cases. OSA could be used as a harmful prognostic factor of visual activity improvement and ME incidences. These findings highlighted the role of OSA in the development of RVO.Keywords: obstructive sleep apnea, retinal vein occlusion, risk factor, prognosis, oxidative stress

Keywords

• obstructive sleep apnea
• retinal vein occlusion
• risk factor
• prognosis
• oxidative stress