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Sleep-disordered breathing and retinal microvascular diameter.

Anoop Shankar¹, Paul E Peppard, Terry Young

¹Department of Community Medicine, West Virginia University School of Medicine, 1 Medical Center Drive, PO Box 9190, Morgantown, WV 26506, USA. ashankar@hsc.wvu.edu

Atherosclerosis

|November 10, 2012

Summary

This summary is machine-generated.

Sleep-disordered breathing (SDB) is linked to wider retinal venules, a sign of microvascular changes. This finding, independent of common health factors, suggests SDB may contribute to cardiovascular disease through microvascular pathways.

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Area of Science:

Ophthalmology
Cardiology
Sleep Medicine

Background:

Sleep-disordered breathing (SDB) is an emerging risk factor for cardiovascular disease (CVD).
Microvascular dysfunction is a proposed mechanism linking SDB to CVD.
Retinal vasculature allows non-invasive assessment of systemic microvascular health.

Purpose of the Study:

To examine the association between SDB and retinal microvascular diameter.
To investigate if SDB impacts retinal arteriolar and venular dimensions.
To adjust for major cardiovascular confounders in the analysis.

Main Methods:

Analysis of 476 participants from the Wisconsin Sleep Cohort Study.
SDB classification based on apnea-hypopnea index (AHI) categories: <5, 5-14.9, and ≥15 events/h.
Outcomes: retinal arteriolar narrowing (<141.0 µm) and venular widening (>223.0 µm).

Main Results:

Higher AHI positively associated with retinal venular widening.
Multivariable-adjusted odds ratio for venular widening: 1.31 (5-14.9 AHI) and 2.08 (≥15 AHI) vs. <5 AHI (p-trend=0.045).
No significant association found between AHI and retinal arteriolar narrowing (p-trend=0.72).

Conclusions:

Elevated AHI in SDB is associated with wider retinal venules.
This association is independent of age, gender, BMI, hypertension, diabetes, and lipid levels.
Retinal microvascular changes suggest SDB may contribute to CVD via microvasculature.