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Abstract #3557 Published in IGR 4-2
Association between sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy
Mojon DS; Hedges 3rd TR; Ehrenberg B; Karam EZ; Goldblum D; Abou Chebl A; Gugger M; Mathis JArchives of Ophthalmology 2002; 120: 601-605
OBJECTIVE: To determine if patients with nonarteritic ischemic optic neuropathy (NAION) have sleep apnea syndrome (SAS), an entity characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption. METHODS: The authors recruited 17 patients with NAION and 17 age- and sex-matched controls from patients referred for treatment because of suspected restless legs syndrome. They performed overnight polysomnography and determined the respiratory disturbance index during night sleep, a value used to diagnose and grade SAS. They compared the proportions of patients with SAS among patients with NAION and matched controls using the Χ2 test. Additionally, the authors compared the proportions of patients with SAS among patients with NAION and a large SAS prevalence study using the binomial test. RESULTS: Twelve (71%) of 17 patients with NAION had SAS. According to the respiratory disturbance index, four patients (24%) had mild, four (24%) had moderate, and four (24%) had severe SAS. Only three (18%) of 17 controls had SAS (p = 0.005). In the 45- to 64-year age group, four (50%) of eight patients with NAION had SAS; 51 (11.9%) of 430 of the random sample in the prevalence study had SAS (p = 0.005). In the group older than 64 years, eight (89%) of nine patients with NAION had SAS; 18 (24%) of 75 of the random sample in the prevalence study had SAS (p < 0.001). CONCLUSIONS: The authors found a high prevalence of SAS in patients with NAION, which supports previous case reports suggesting that such an association exists. This association may explain why approximately 75% of all patients with NAION discover visual loss on first awakening or when they first use vision critically after sleeping. These findings indicate that SAS may play an important role in the pathogenesis of NAION.
Dr. D.S. Mojon, New England Eye Center, 750 Washington St, Box 381, Boston, MA 02111, USA.
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
