Zespół obturacyjnego bezdechu śródsennego jako czynnik ryzyka neuropatii jaskrowej

The consequences of sleep apneas in patients with obstructive sleep apnea (OSA) syndrome may influence the function of visual system. In 21 patients with OSA syndrome (apnea / hypopnea index – AHI 50±20) the detailed ophthalmologic studies, including tonometry, biomicroscopic evaluation of the anterior segment of the eye, automatic perimetry and stereoscopic examination of the eye fundus have been performed. In 4 patients (19%) the signs of lesions in the optic tract have been found. These were: defects in visual field caused by glaucoma (primary open-angle glaucoma and normal-tension glaucoma) in 2 patients and defects in visual field (concentric and quadrantic homonymous) caused by diffuse lesions in the cortico-nuclear tract in 2 patients. In patients with the lesions in the optic tract there were severe disorders of breathing during sleep: AHI >60, mean SaO2 at the end of the apneas <86% and minimal SaO2 at the end of the apneas <70%. The authors conclude that in OSA patients there is a high risk of the lesions of the optic tract as a consequence of severe and repetitive hypoxemia during sleep.