Corneal Epithelial Thickness Patterns In Obstructive Sleep Apnea Syndrome Evaluated By Swept-Source As-Oct

Published 2026 - 44th Congress of the ESCRS

Reference: PP19.15 | Type: Free paper | DOI: 10.82333/v242-7z30

Authors: Dr Azad Güçlü* ¹ , Dr Ömer Köroğlu ¹ , Prof. Dr Sezai Taşbakan ² , Prof. Dr Özen Kaçmaz Başoğlu ² , Prof. Dr Melis Palamar ¹

¹Department of Ophthalmology,Ege University,Izmir,Türkiye, ²Department of Pulmonology,Ege University,Izmir,Türkiye

Purpose

To evaluate corneal epithelial thickness patterns in patients with obstructive sleep apnea syndrome (OSAS) using swept-source anterior segment optical coherence tomography (AS-OCT), and to compare inferior–superior (I–S) epithelial thickness difference and maximum–minimum (max–min) epithelial thickness difference among control, mild, moderate, and severe OSAS groups.

Setting

This study was conducted at the Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkiye, involving patients diagnosed with OSAS and healthy control subjects.

Methods

This cross-sectional case–control study included 154 eyes of 77 patients. Patients were classified into mild, moderate, and severe OSAS groups based on the apnea–hypopnea index, while healthy individuals served as controls. All participants underwent ocular surface evaluation. Corneal epithelial thickness maps were obtained using swept-source AS-OCT (Anterion, Heidelberg Engineering). Mean central epithelial thickness, inferior–superior (I–S), and maximum–minimum (max–min) epithelial thickness differences were analyzed. Group comparisons were performed using the Kruskal–Wallis test with post-hoc analyses.

Results

Mean corneal epithelial thickness differed significantly among the groups (control: 47.75 ± 2.42 µm; mild OSAS: 49.50 ± 1.99 µm; moderate OSAS: 48.70 ± 2.95 µm; severe OSAS: 48.28 ± 2.84 µm; p=0.033). No significant difference was observed in I–S epithelial thickness difference (p=0.18). In contrast, the max–min epithelial thickness difference showed a significant variation among the groups (control: 15.35 ± 3.84 µm; mild: 18.32 ± 5.23 µm; moderate: 19.13 ± 5.75 µm; severe: 20.78 ± 4.69 µm; p=0.000014). Post-hoc analyses demonstrated significant differences between the control and moderate and severe OSAS groups.

Conclusions

Although mean corneal epithelial thickness is largely preserved in OSAS, epithelial thickness distribution demonstrates increased heterogeneity with disease severity. The maximum–minimum epithelial thickness difference appears to be a sensitive parameter reflecting OSAS-related epithelial irregularity. Swept-source AS-OCT–based epithelial thickness pattern analysis may provide clinically relevant information beyond mean thickness measurements in the assessment of corneal involvement in OSAS.