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Updated: Jul 25, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Papilledema and obstructive sleep apnea syndrome
V A Purvin1, A Kawasaki, R D Yee
1Midwest Eye Institute, 201 Pennsylvania Pkwy, Indianapolis, IN 46280, USA. vpurvin@iupui.edu
Archives of Ophthalmology (Chicago, Ill. : 1960)
|December 15, 2000
Summary
Obstructive sleep apnea syndrome (SAS) can cause optic disc edema due to nocturnal intracranial pressure (ICP) spikes. Early diagnosis is crucial to prevent vision loss in these patients.
Area of Science:
- Neuro-ophthalmology
- Sleep Medicine
- Neurology
Background:
- Obstructive sleep apnea syndrome (SAS) is a prevalent condition often associated with various systemic complications.
- Optic disc edema (papilledema) is a critical sign of increased intracranial pressure (ICP), potentially leading to vision loss.
Observation:
- Four patients with SAS presented with bilateral optic disc edema (papilledema).
- Neuro-ophthalmologic evaluations revealed optic nerve dysfunction in three patients.
- While daytime cerebrospinal fluid pressure was normal, nocturnal ICP monitoring showed significant elevations linked to apneic events and oxygen desaturation.
Findings:
- Episodic nocturnal hypoxemia and hypercarbia in SAS patients lead to cerebral vasodilation and transient ICP increases.
- Intermittent ICP elevation is sufficient to cause persistent optic disc edema.
- Patients with SAS-associated papilledema may face a higher risk of visual impairment compared to those with obesity-related pseudotumor cerebri due to associated hypoxemia.
Implications:
- The diagnosis of SAS-related papilledema can be missed due to normal daytime ICP measurements and atypical presentations.
- Increased awareness and diagnostic evaluation for SAS are essential in patients presenting with unexplained optic disc edema.
- Prompt management of SAS may be vital in preventing irreversible visual loss.
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