Meta-Analysis: Characteristics of Retinal Vasculature in Obstructive Sleep Apnea Syndrome Humans

Abstract

Background. The objective of this study is to determine optic nerve head vascular changes in patients with obstructive sleep apnea-hypopnea syndrome (OSAS) by utilizing an optical coherence tomography angiography (OCTA) device. Methods. A detailed studies search was screened in the PubMed, Embase, the Cochrane Library, and Web of Science databases from inception to August 2023. We reviewed and examined optic nerve head vascular density in eyes with OSAS and controls. The mean difference and 95% confidence interval were calculated to evaluate continuous outcomes. Review Manager version 5.4.1 was applied for analysing pooled data. Results. Six eligible studies were included in our meta-analysis. The radial peripapillary capillary (RPC) whole enface vessel density (VD) measured by OCTA in the mild-to-moderate and severe OSAS groups was significantly lower compared to the controls (MD = −0.96, P=0.03; MD = −1.42, P=0.001, respectively). For RPC peripapillary VD, eyes in mild-to-moderate OSAS showed a trending decrease compared to the controls (MD = −1.71, P=0.05), and there was a remarkable difference between eyes with severe OSAS and the controls (MD = −3.08, P=0.004). In addition, the RPC inside disc VD was decreased in severe OSAS eyes than in the controls (MD = −0.07, P=0.94). Conclusions. Our results revealed that peripapillary vascular density was attenuated in patients with OSAS. Moreover, on the basis of these findings, we suggest that optic nerve head vascular density measured by OCTA may be used as a potential tool to diagnose and monitor the severity of patients with OSAS.