阻塞性睡眠呼吸暂停综合征患者黄斑区GCIPL厚度的观察研究

Thickness of macular ganglion cell-inner plexiform layer in patients with obstructive sleep apnea syndrome

摘要:

目的：研究阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）患者的黄斑区神经节细胞层和内丛状层（macular ganglion cell-inner plexiform layer，GCIPL）厚度是否发生改变，为OSAS患者预防眼部并发症提供依据。方法：选取重庆市急救医疗中心及市人民医院的124例确诊OSAS者为观察组，67例正常人为对照组，均取右眼作为研究对象，运用光学相干断层扫描仪（optical coherence tomography，OCT）测量2组患者黄斑区平均GCIPL厚度、最小GCIPL厚度及黄斑区各区GCI－PL厚度。结果：观察组平均GCIPL厚度、最小GCIPL厚度及各区GCIPL厚度均小于对照组，2组黄斑区平均GCIPL厚度、最小GCIPL厚度、上方GCIPL厚度、鼻上方GCIPL厚度、鼻下方GCIPL厚度、下方GCIPL厚度、颞下方GCIPL厚度、颞上方GCIPL厚度差异均具有统计学意义（t=3.335，P=0.001；t=2.491，P=0.014；t=2.822，P=0.005；t=2.567，P=0.011；t=3.046，P=0.003；t=3.279，P=0.001；t=3.432，P=0.001；t=3.086，P=0.002）。结论：OSAS患者黄斑区平均GCIPL厚度、最小GCIPL厚度及各区GCIPL厚度均较对照组变薄。OSAS患者在出现相应眼科临床症状前，其黄斑区GCIPL层变薄，与早期开角型青光眼黄斑区改变类似，OSAS患者缺氧和对血流灌注的影响可能是黄斑部视网膜神经节细胞丢失的高危因素。

Abstract:

Objective：To investigate the change of macular ganglion cell-inner plexiform layer（GCIPL） thickness in the patients with obstructive sleep apnea syndrome（OSAS），so as to provide references to prevent ocular complications in OSAS. Methods：In this study，right eyes of 124 OSAS patients from Chongqing Emergency Medical Center and The People’s Hospital of Chongqing and 67 healthy people were enrolled. Cirrus high-definition optical coherence tomography（HD-OCT） was used to measure the average macular GCIPL thickness，the minimum macular GCIPL thickness and the GCIPL thickness of all macular areas. Results：The average macular GCIPL thickness，the minimum macular GCIPL thickness and the GCIPL thickness of all macular areas in the observation group were less than those in the control group. The average macular GCIPL thickness，the minimum macular GCIPL thickness，the superior GCIPL，the superior-nasal GCIPL，the inferior-nasal GCIPL，the inferior GCIPL，the inferior-temporal GCIPL and the super-temporal GCIPL thickness in the OSAS group were lower than those in the control group（t=3.335，P=0.001；t=2.491，P=0.014；t=2.822，P=0.005；t=2.567，P=0.011；t=3.046，P=0.003；t=3.279，P=0.001；t=3.432，P=0.001；t=3.086，P=0.002）. Conclusion：The average GCIPL thickness，the minimum GCIPL thickness and the GCIPL thickness of all macular areas in OSAS patients become thinner than those people of the control group. Before the significant syndrome，their macular GCIPL become thinner，which is similar with the early-stage open angle glaucoma macular change. Anoxia and influence on blood flow in OSAS patients may be high risk factors of losing macular retinal ganglion cells.