关键词: 睡眠呼吸暂停,阻塞性, 眼动脉, 视网膜中央动脉, 血流动力学参数, 超声检查,多普勒,彩色

Abstract: Objective The objective of this study is to evaluate the correlation between the hemodynamic parameters of the ophthalmic artery(OA)and the central retinal artery(CRA)in patients diagnosed with severe obstructive sleep apnea(OSA), as well as their apnea-hypopnea index(AHI)and lowest nocturnal oxygen saturation(LSaO₂). Methods Thirty patients diagnosed with severe OSA were included in the study, The study population comprised 27 men and 3 women, with an average age of 43.08±4.86 years. A 1:1 propensity score matching(PSM)procedure was employed to select matched controls from healthy participants recruited during the same period, with the selection based on variables such as age, sex and body mass index(BMI). All subjects underwent full-night polysomnography(PSG), Epworth sleepiness Scale(ESS), intraocular pressure(IOP), and color Doppler ultrasound(CDU)tests. The present study utilised the continuous Doppler ultrasound(CDU)to assess various parameters of ocular blood flow, namely the peak systolic velocity(PSV), the end-diastolic velocity(EDV), the mean flow velocity(MFV), the pulsatility index(PI), and the resistance index(RI)of the ophthalmic artery(OA)and the central retinal artery(CRA).The random number table method was employed to ensure the randomisation of measurements across both eyes. The present study sought to analyse the correlations between hemodynamic parameters and AHI and LSaO₂. Results The IOP of the severe OSA group was found to be statistically higher than that of the control group(t=2.293, q<0.05). In the OSA group, the levels of CRA PSV, CRA EDV, OA PSV and OA EDV were found to be significantly lower(p<0.001;Table 1). The investigation revealed a significant negative correlation between CRA PSV and AHI in the severe OSA group(r=-0.478, P=0.008). Additionally, a similar correlation was observed between CRA PSV and LSaO₂ in the severe OSA group(r=-0.362, P=0.049). Furthermore, the investigation revealed a significant negative correlation between OA PSV and AHI(r=-0.395, P=0.031). In addition, a similar correlation was observed between OA PSV and LSaO₂(r=-0.481, P=0.007). Multivariate linear regression analysis indicated that AHI and LSaO₂ independently predicted reductions in CRA PSV in severe OSA patients(b=-0.064, P<0.05; b=-0.067, P<0.05), and LSaO₂ was an independent factor related to reduced OA PSV(b=-0.170, P<0.05). Conclusion Patients diagnosed with severe OSA have been shown to exhibit increased intraocular pressure(IOP)and decreased blood flow velocities in OA and CRA. The degree of hemodynamic abnormalities has been shown to be independently associated with AHI and LSaO₂ levels, suggesting that intermittent chronic hypoxia may have a detrimental effect on the microcirculation of the retinal blood supply.

Key words: Sleep apnea, obstructive, Ophthalmic artery, Central retinal artery, Hemodynamic parameters, Ultrasonography,doppler, color