Objective:
To investigate the long-term vascular effects of treating obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) using retinal imaging.
Approach:
- Study Design: A prospective seven-year study following participants from an earlier OSA cohort, assessing retinal vessel imaging and other parameters.
- Participants: 79 participants were eligible from the two-year follow-up, with 39 completing the seven-year assessment.
- Measurements: Evaluated central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), arteriovenous ratio, and retinal nerve fiber layer (RNFL) thickness.
- Stratification: Participants were stratified by OSA severity and CPAP adherence.
Key Findings:
- Mean CRAE was 161.0 in CPAP-treated patients compared to 143.2 in untreated patients.
- Mean CRVE was 200.9 in CPAP users versus 186.9 in non-users.
- Longitudinal data suggested slower retinal vascular narrowing among CPAP users.
- Severe OSA patients on CPAP showed a smaller decline in CRAE and better preservation of CRVE over seven years.
- Superotemporal RNFL was thicker in CPAP users than in untreated counterparts.
Limitations:
- Small sample size with almost half of the original cohort lost to follow-up.
- Several subgroups contained very few participants.
- Inability to perform multivariable adjustment for major vascular comorbidities.
- CPAP adherence assessed only for the 90 days preceding the ophthalmic visit.
Sources:
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