engleski

Neuroophthalmological disorders associated with obstructive sleep apnoea

Sleep apnoea (SA) is the most common form of breathing disorder during sleep and is often associated with increased body weight. It causes recurrent pauses in breathing during sleep and transient nocturnal hypoxia and hypercapnia. The most common type accounting for over 85% of all SA cases is obstructive SA (OSA) characterized by repetitive episodes of upper airway obstruction during sleep. It is a condition with a high prevalence being estimated to affect 22–24% of men and 9–17% of women globally. Despite being a common disorder with increasing prevalence many cases still remain undiagnosed. OSA significantly impacts the quality of life and is recognized to cause various systemic changes including those on the eye and central nervous system. OSA has been identified as a significant risk factor for a number of neuro-ophthalmic conditions including non-arteritic anterior ischemic optic neuropathy (NAION). Patients with NAION have a significantly higher incidence of OSA, at the same time OSA diagnosis significantly increases the risk for NAION development. Evidence also suggests a connection between OSA and idiopathic intracranial hypertension (IIH), glaucoma and stroke. Treatment with continuous positive airway pressure (CPAP) has been seen to reverses some pathological changes, however with limited evidence. Whilst it is well established that OSA is associated with various neuroophthalmological disorders larger scale studies are necessary to investigate the role of OSA as a risk factor. OSA is under- recognized and ophthalmologists may be uniquely positioned to identify at-risk patients presenting with certain eye disorders. The role of treatment with CPAP, the reversibility of pathology as well as the long-term impact of OSA on health outcomes also need to be addressed.

obstructive sleep apnoea ; neuroophthalmological disorders ; non-arteritic anterior ischemic optic neuropathy ; idiopathic intracranial hypertension ; glaucoma ; stroke

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