Effect of obstructive sleep apnoea on retinal microvascular function: a randomised controlled trial.
Author
Turnbull, Chris DStockley, James A
Madathil, Shyam
Huq, Syed S A
Cooper, Brendan G
Ali, Asad
Wharton, Simon
Stradling, John R
Heitmar, Rebekka
Publication date
2022-02-24
Metadata
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Purpose: Retinal microvascular endothelial dysfunction is thought to be of importance in the development of ocular vascular diseases. Obstructive sleep apnoea (OSA) causes macrovascular endothelial dysfunction, but the effect of OSA on retinal microvascular endothelial function is not known. We aimed to determine the effect of OSA on retinal microvascular function. Methods: We conducted a multi-centre, double-blind, randomised, parallel, controlled trial in patients with known moderate-to-severe OSA, established on continuous positive airway pressure (CPAP). Participants were randomised to 14 nights of either continued CPAP or sham CPAP to generate a return of OSA. Retinal vascular responses to flickering light were measured using dynamic vessel analysis both at baseline and after 14 nights of intervention. The primary outcome was the change from baseline to follow-up in the area under the curve of the arteriolar response to flickering light, sham CPAP versus continued CPAP. Results: Nineteen patients were randomised to sham CPAP, and 18 patients were randomised to continued CPAP. There was no significant effect of CPAP withdrawal and return of OSA on retinal responses, with a change in the area under the curve of the arteriole response to flickering light of + 3.8 arbitrary units (95% CI - 10.6 to + 18.2, p = 0.59), sham CPAP versus continued CPAP. Conclusions: CPAP withdrawal and a return of OSA had no significant effect on retinal microvascular responses. This contrasts with the effect of CPAP withdrawal on macrovascular endothelial function and suggests that OSA has different effects on macrovascular and microvascular endothelial function. ISRCTN 78082983, 23/10/2014, Prospectively registered.Citation
Turnbull CD, Stockley JA, Madathil S, Huq SSA, Cooper BG, Ali A, Wharton S, Stradling JR, Heitmar R. Effect of obstructive sleep apnoea on retinal microvascular function: a randomised controlled trial. Graefes Arch Clin Exp Ophthalmol. 2022 Jul;260(7):2129-2139. doi: 10.1007/s00417-022-05596-8. Epub 2022 Feb 24Type
ArticleAdditional Links
https://link.springer.com/journal/417PMID
35201404Publisher
Springerae974a485f413a2113503eed53cd6c53
10.1007/s00417-022-05596-8