OCULAR SURFACE EVALUATION IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA

Abstract

Background. Obstructive sleep apnea (OSA) is a chronic condition that causes intermittent hypoxemia and induces a systemic inflammatory response of the human body, including the ocular surface. Significant ocular involvement plays a key role in the pathogenesis of dry eye syndrome (DES), which manifests with different symptoms of eye discomfort. The aim of the study. To evaluate the ocular surface in patients with OSA. Methods. 43 patients with confirmed OSA by polysomnography and 10 healthy subjects without OSA were included in the study. The data from patients’ case histories were collected: apnea–hypopnea index (AHI), age, gender, body mass index (BMI) and mean oxygen saturation during sleep. Patients completed questionnaires dedicated to the ocular surface disease index (OSDI), and Schirmer’s tests were done. Results. According to AHI, in 20.9% of cases, OSA was mild, in 32.6% – moderate and in the remaining 46.5% – severe. In OSA patients Schirmer’s test values median was 7.5 (2–35) mm versus 15.5 (3–25) mm in the control group (p=0.019). The control group’s OSDI scores median was 17.7 (2.1–60) versus 38.8 (2.1–87.5) in the OSA group (p=0.086). A moderate negative correlation was found between AHI values, and lacrimal secretion (r=–0.33, p=0.02), also between Schirmer‘s test values and OSDI scores (r=–0,49, p=0,001) and a moderate positive correlation was found between AHI values and OSDI scores (r=0.29, p=0.03). Conclusions: OSA patients had lower lacrimal secretion and a tendency to complain of more severe dry eye disease symptoms than patients without OSA. Higher AHI correlated with lower lacrimal secretion and more severe DES complaints.