Obstriktif uyku apne sendromu hastalarında oküler yüzey değerlendirmesi
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Obstrüktif uyku apne sendromu (OUAS); gündüz uyku hali, horlama gibi şikayetlerle seyreden uyku sırasında tekrarlayan üst solunum yolu obstrüksiyonu ataklarıyla karakterize bir hastalıktır. Bu çalışmanın amacı OUAS hastalarında oküler yüzey özelliklerinin değerlendirilmesidir. Yöntem: Bu prospektif çalışmaya polisomnografi tetkikinde OUAS tanısı alan 77 hasta ve 29 sağlıklı kişiden oluşan kontrol grubu dahil edildi. OUAS hastaları apne-hipopne indeksine (AHİ) göre; ağır (n=27) , orta (n=27) , hafif OAUS (n=23) olarak sınıflandırıldı. Katılımcılara tam oftalmolojik muayene yapıldı. Katılımcıların her iki gözü gözyaşı kırılma zamanı (GKZ), Schirmer I testi, konjoktival impresyon sitolojisi (KİS) skoru açısından değerlendirildi. Her bir katılımcıya oküler yüzey hastalık indeksi (OYHİ) anketi uygulandı. Sonuçlar gruplar arasında istatistiksel olarak karşılaştırıldı. Bulgular: OYHİ skorları ağır OUAS grubunda 20,31±19,87, orta OUAS grubunda 25,06±19,45, hafif OUAS grubunda 11,52±12,95, kontrol grubunda 12,76±14,84 idi (p=0,015). GKZ değeri; ağır OUAS grubunda 5,44±3,09, orta OUAS grubunda 6,26±3,48, hafif OUAS grubunda 11,04±6,22 ve kontrol grubunda 9,83±5,03 idi (p<0,001). Schirmer I testi; ağır OUAS grubunda 9,41±7,53, orta OUAS grubunda 9,85±7,81, hafif OUAS grubunda 13,39±8,80 ve kontrol grubunda 15,03±10,16 idi (p<0,002). KİS skoru; ağır OUAS grubunda 1,83±0,69, orta OUAS grubunda 1,52±0,75, hafif OUAS grubunda 0,89±0,74 ve kontrol grubunda 0,47±0,60 idi (p<0,001). OUAS hastaları kontrol grubuyla karşılaştırıldığında OYHİ skoru ve KİS skorunun yüksek, GKZ ve Schirmer değerlerinin düşük olduğu görüldü. Ayrıca OUAS hastalarında AHİ değeri ile; GKZ (r=-0,32, p=0,005) arasında negatif ve KİS skoru (r=0,43, p<0,001) arasında pozitif korelasyon olduğu bulundu. Sonuç: OUAS hastalarında artmış OYHİ, azalmış GKZ ve Schirmer I sonuçları kuru göz hastalığına yatkınlığı desteklemektedir. Bunun yanında OUAS hastalarında hastalığın şiddeti ile pozitif korelasyon gösteren konjonktival goblet hücresi kaybı ve skuamöz metaplazi gelişimi dikkat çekmektedir.
Obstructive sleep apnea syndrome (OSAS); is a disease characterized by recurrent episodes of upper respiratory tract obstruction during sleep, with complaints such as daytime sleepiness, snoring. The aim of this study is to evaluate ocular surface changes in patients with OSAS. Methods: This prospective study involved 77 patients who underwent polysomnography and were diagnosed as OSAS and 29 healthy subjects. OSAS patients were grouped as severe (n=27), moderate (n=27) and mild (n=23) OSAS according to apnea-hypopnea index (AHI) values. The subjects underwent a complete ophthalmic examination. The both eyes of the subjects were tested for the study including tear break-up time (TBUT), Schirmer I test and conjunctival impression cytology (CIC). The Ocular Surface Disease Index (OSDI) questionnaire was completed for each subject. The results were compared statistically between groups. Results: OSDI values were as follows: severe OSAS group 20,31±19,87; moderate OSAS group 25,06±19,45; mild OSAS group 11,52±12,95; control group 12,76±14,84 (p=0,015). TBUT values were as follows: severe OSAS group 5,44±3,09; moderate OSAS group 6,26±3,48; mild OSAS group 11,04±6,22; control group 9,83±5,03 (p<0,001). Schirmer I values were as follows: severe OSAS group 9,41±7,53; moderate OSAS group 9,85±7,81; mild OSAS group 13,39±8,80; control group 15,03±10,16 (p<0,002). The CIC scores were as follows: severe OSAS group 1,83±0,69; moderate OSAS group 1,52±0,75; mild OSAS group 0,89±0,74; control group 0,47±0,60 (p<0,001). When OSAS patients were compared with the control group, it was observed that the OSDI score and CIC score were higher, and the TBUT and Schirmer I values were lower. In addition, in OSAS patients, there was a negative correlation between AHI value and TBUT (r = -0,32, p = 0,005) and there was a positive correlation between AHI value and CIC score (r = 0,43, p <0,001). Conclusion: Increased OSDI scores, decreased TBUT and Schirmer I results support that, there could be a predisposition to dry eye in OSAS patients. In addition, a positive correlation was determined between the severity of OSAS and conjunctival goblet cell loss with squamous metaplasia in the conjunctival epithelium cells.
Obstructive sleep apnea syndrome (OSAS); is a disease characterized by recurrent episodes of upper respiratory tract obstruction during sleep, with complaints such as daytime sleepiness, snoring. The aim of this study is to evaluate ocular surface changes in patients with OSAS. Methods: This prospective study involved 77 patients who underwent polysomnography and were diagnosed as OSAS and 29 healthy subjects. OSAS patients were grouped as severe (n=27), moderate (n=27) and mild (n=23) OSAS according to apnea-hypopnea index (AHI) values. The subjects underwent a complete ophthalmic examination. The both eyes of the subjects were tested for the study including tear break-up time (TBUT), Schirmer I test and conjunctival impression cytology (CIC). The Ocular Surface Disease Index (OSDI) questionnaire was completed for each subject. The results were compared statistically between groups. Results: OSDI values were as follows: severe OSAS group 20,31±19,87; moderate OSAS group 25,06±19,45; mild OSAS group 11,52±12,95; control group 12,76±14,84 (p=0,015). TBUT values were as follows: severe OSAS group 5,44±3,09; moderate OSAS group 6,26±3,48; mild OSAS group 11,04±6,22; control group 9,83±5,03 (p<0,001). Schirmer I values were as follows: severe OSAS group 9,41±7,53; moderate OSAS group 9,85±7,81; mild OSAS group 13,39±8,80; control group 15,03±10,16 (p<0,002). The CIC scores were as follows: severe OSAS group 1,83±0,69; moderate OSAS group 1,52±0,75; mild OSAS group 0,89±0,74; control group 0,47±0,60 (p<0,001). When OSAS patients were compared with the control group, it was observed that the OSDI score and CIC score were higher, and the TBUT and Schirmer I values were lower. In addition, in OSAS patients, there was a negative correlation between AHI value and TBUT (r = -0,32, p = 0,005) and there was a positive correlation between AHI value and CIC score (r = 0,43, p <0,001). Conclusion: Increased OSDI scores, decreased TBUT and Schirmer I results support that, there could be a predisposition to dry eye in OSAS patients. In addition, a positive correlation was determined between the severity of OSAS and conjunctival goblet cell loss with squamous metaplasia in the conjunctival epithelium cells.
Açıklama
Anahtar Kelimeler
Uyku apne sendromu, Sleep apnea syndrome
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Güneş, İ. (2020). Obstriktif uyku apne sendromu hastalarında oküler yüzey değerlendirmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Göz Hastalıkları Anabilim Dalı, Konya.
