Maha Yousif

Retinal vascular tortuosity in patients with obstructive sleep apnea-chronic obstructive pulmonary disease overlap syndrome

Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are linked with microvascular changes. Retinal microvasculature can be examined in a direct noninvasive way. Aim The aim was to evaluate tortuosity of the retinal vessels in patients with COPD, OSA, and overlap syndrome. Patients and methods A total of 60 participants were included: 15 patients with OSA, 15 patients with COPD, 15 patients with COPD-OSA overlap syndrome, and 15 matched controls. All participants underwent digital retinal photography, polysomnography, arterial blood gases, spirometry, Epworth sleepiness scale, and STOP-BANG questionnaires. Results Tortuosity of most retinal vessels was higher in all patient groups when compared with the control group, and tortuosity was more marked in the overlap syndrome group. There was a negative correlation between tortuosity of retinal vessels and PO2, O2 saturation, and minimum O2 saturation, and a positive correlation with PCO2, apnea hypopnea index, O2 desaturation index, BMI, and smoking index. Conclusion Retinal vascular tortuosity occurs in OSA, COPD, and overlap syndrome. Retinal vascular tortuosity is correlated with arterial blood gases parameters, polysomnographic findings, smoking index, and BMI.