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Retinal Nerve Fiber Layer Thickness Alteration in Apneic Children
Ali Simsek1, Cem Bayraktar, Sedat Dogan
1*MD †PhD Departments of Ophthalmology (AS, AHR, MC), Otolaryngology Head and Neck Surgery (CB, SD, YS, MK), and Biostatistics and Medical Informatics (FU), Adıyaman University Research and Education Hospital, Adıyaman, Turkey.
Insights
Children with upper airway obstruction (UAO) and obstructive sleep apnea syndrome (OSAS) showed changes in retinal nerve fiber layer (RNFL) thickness and intraocular pressure (IOP). Adenotonsillectomy improved these eye parameters.
Area of Science:
- Ophthalmology
- Pediatrics
- Sleep Medicine
Background:
- Chronic upper airway obstructions (UAOs) in children can lead to obstructive sleep apnea syndrome (OSAS).
- Ocular changes, including retinal nerve fiber layer (RNFL) thickness and intraocular pressure (IOP), may be associated with UAOs and OSAS.
- Investigating these ocular parameters can provide insights into the systemic effects of pediatric UAOs and OSAS.
Purpose of the Study:
- To examine alterations in RNFL thickness in children with chronic UAOs and OSAS.
- To determine if these RNFL thickness changes are affected by adenotonsillectomy.
- To assess intraocular pressure (IOP) in relation to UAOs and OSAS in children.
Main Methods:
- A cohort of 42 children (3-8 years) with UAOs due to adenotonsillar enlargement and 34 age-matched controls were studied.
- Patients were categorized into mild, moderate, and severe UAO groups based on the Brouillette scoring questionnaire, with severe UAO defined as OSAS.
- Ophthalmologic evaluations using optical coherence tomography measured RNFL thickness and IOP before and after adenotonsillectomy.
Main Results:
- Preoperative RNFL thickness showed no significant difference between UAO groups and controls.
- Postoperatively, significant differences in superior, inferior, and average RNFL thickness emerged (p < 0.05).
- Intraocular pressure (IOP) levels were significantly lower in mild, moderate, and total UAO groups after surgery (p < 0.05).
Conclusions:
- Pediatric upper airway obstruction and OSAS appear to negatively impact certain RNFL and IOP parameters.
- Adenotonsillectomy demonstrates a positive effect on these ocular measurements.
- Ophthalmologic examinations are valuable for assessing children with UAOs and OSAS.
Purpose:
We examined retinal nerve fiber layer (RNFL) thickness alterations in children with chronic upper airway obstructions (UAOs) and obstructive sleep apnea syndrome (OSAS). We also investigated whether it was affected by an adenotonsillectomy operation.
Methods:
Forty-two children aged 3 to 8 years with chronic UAO resulting from adenotonsillar enlargement and 34 age-matched controls were included in the study. Patients underwent a Brouillette scoring questionnaire to be divided into mild (N = 10), moderate (N = 22), severe (N = 10), and total (N = 42) UAO groups. According to the scoring, the severe UAO group was defined as the severe OSAS group, the moderate group was suspicious for OSAS, and the mild UAO group was defined as the non-OSAS group. The patients' demographic data for age, sex, and body mass index were obtained. Ophthalmologic evaluations were performed with optical coherence tomography. Central corneal thickness, macular thickness, intraocular pressure (IOP), and RNFL thickness were measured. An adenotonsillectomy was performed on all patients, and eye examinations and scoring were repeated after the surgery.
Results:
Higher IOP levels were obtained between the total UAO group and the control group (p > 0.05). There were significant differences between UAO groups and the control group except for the moderate UAO group. There was no significant difference in RNFL thickness (p > 0.05) between preoperative UAO groups and the control group. However, after surgery, some significant differences emerged in the superior, inferior, and average RNFL thickness (p < 0.05). Also, IOP levels were significantly lower in the mild, moderate, and total UAO groups after the operation (p < 0.05).
Conclusions:
Upper airway obstruction and OSAS seem to worsen some RNFL and IOP parameters in children, and eye examinations may be useful in these patients.
