Ocular Surface in Patients with Obstructive Sleep Apnea Syndrome: Evaluation of Clinical Parameters and Impression Cytology
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CitationGüneş, İ., Oltulu, R., Oltulu, P., Türk, N., Yosunkaya, Ş. (2023). Ocular surface in patients with obstructive sleep apnea syndrome: Evaluation of clinical parameters and impression cytology. Eye & Contact Lens-Science And Clinical Practice, 49, 1, 14-18.
Purpose:To evaluate the effect of obstructive sleep apnea syndrome (OSAS) on the ocular surface and conjunctival cytology and the relationship between the findings and disease severity.Methods:One hundred six eyes of 106 patients (77 patients with OSAS and 29 control subjects) were included in the study. Twenty-three patients with an apnea-hypopnea index (AHI) of 5 to 15 were classified as mild OSAS (group 1), 27 patients with an AHI of 15 to 30 were classified as moderate OSAS (group 2), and 27 patients with an AHI >= 30 were classified as severe OSAS (group 3). The following tests were used to evaluate the ocular surface: tear break-up time (TBUT), Schirmer I test, ocular surface disease index (OSDI), and conjunctival impression cytology (CIC). The results obtained from the tests were analyzed and compared between the groups.Results:The mean value of the Schirmer I test was 15.03 +/- 10.16 (1-35) mm in the control group, whereas it was found as 13.39 +/- 8.80 (3-35) mm, 9.85 +/- 7.81 (1-30) mm, and 9.41 +/- 7.53 (2-35) mm in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant (P=0.002). Although the mean TBUT score was 9.83 +/- 5.03 (3-23) seconds in the control group, it was 11.04 +/- 6.22 (3-20), 6.26 +/- 3.48 (1-16), and 5.44 +/- 3.09 (1-10) in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant (P<0.001). Although the mean OSDI score was 12.76 +/- 14.84 (range, 0-41.65) in the control group, it was 11.52 +/- 12.95 (range, 0-44.40), 25.06 +/- 19.45 (range, 0-75), and 20.31 +/- 19.87 (range, 0-77.70) in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant (P=0.015). Although the mean CIC stage was 0.47 +/- 0.60 (0-2) in the control group, it was 0.89 +/- 0.74 (0-2), 1.52 +/- 0.75 (0-3), and 1.83 +/- 0.69 (1-3) in the mild, moderate, and severe OSAS groups, respectively, and the difference between groups was significant (P<0.001).Conclusion:In addition to decreased tear production and TBUT, cytological changes including squamous metaplasia were detected between patients with OSAS and the control group.