Evaluation Of Anatomical-Functional Parameters Of Ocular Surface Alteration In Patients With Obstructive Sleep Apnea-Hypopnea Syndrome

Obstructive sleep apnea-hypopnea syndrome (OSAS) represents a significant risk factor for systemic diseases and certain ocular pathologies including dry eye. OSAS is the cause of dysfunction of the lacrimal glands and meibomien glands, leading to dry eye syndrome (DES) due to aqueous deficiency and evaporation, respectively. This study aims to evaluate the changes in the anatomical-functional parameters of the ocular surface in patients with OSAS and their correlation with its severity.

A prospective cross-sectional study included 62 patients (124 eyes) with OSAS, of whom 25 patients were classified as mild OSAS, 18 as moderate OSAS, 19 as severe OSAS, compared to 42 healthy volunteer subjects (84 eyes). 

In order to assess the ocular surface, the following tests were performed: Tear meniscus height (TMH), First non-invasive tear film breakup time (FNITBUT), Mean non-invasive tear film breakup time (MNITBUT), Meibomien gland marginal zone score (Meiboscore), Schirmer I breakup test without anaesthesia (SIT), Corneal fluorescein staining (CFS), Partial blink rate (PBR), Lipid layer thickness (LLT), Ocular surface disease index (OSDI).The results obtained from the study were analysed and compared between groups

While HML,FNITBUT and MNITBUT were lower,OSDI,CFS,Meiboscore and TCP were higher in the OSAS group than in the control group.The mild, moderate and severe OSAS subgroups had statistically significantly lower HML and higher OSDI and TCP than in the control group.The CFS score was higher in the severe OSAS than in the mild and moderate OSAS subgroups.The significantly lower FNITBUT,MNITBUT and higher Meiboscore were observed in the severe OSAS subgroup than in the control group.LLT and SIT did not show significant differences between OSAS and control groups.FNITBUT and MNITBUT showed significant negative correlations with BMI,while Meiboscore showed a significant positive correlation with AHI.

OSAS patients tend to have dry eyes, which is not the case in control subjects. This indicates that OSAS patients should pay more attention to ocular surface care.