Obstructive Sleep Apnea and the Retina: A Review.

Abstract

NONE\nThis review s objective was to synthesize the literature on the repercussions of obstructive sleep apnea (OSA) in the retinal vascular system. Two independent investigators conducted a search using the MEDLINE/PubMed database using the following terms: sleep apnea syndrome; obstructive sleep apnea; retina; vascular tortuosity; central serous chorioretinopathy; diabetes mellitus; and subfoveal choroidal thickness. OSA patients present increased vascular tortuosity compared to non-OSA patients, decreased parafoveal and peripapillary vessel density, and increased retinal vein occlusion incidence. In central serous chorioretinopathy patients and patients with poor responders to intravitreal anti-VEGF treatment for macular edema, OSA is more frequent. Macular choroidal thickness alterations are controversial, and OSA may worsen diabetic maculopathy, thus being a risk factor for diabetic retinopathy, proliferative diabetic retinopathy, and macular edema. OSA is a prevalent syndrome with many systemic vascular changes. The retina and choroid are the most affected ocular structures, with primarily vascular changes. New non-invasive technologies such as OCT and OCT-A could better understand retinal structures and help clarify the ophthalmological repercussions of OSA.