Why should we systematically screen sleep apnea syndrome in RVO patients?

Abstract

AbstractPurpose Sleep apnea syndrome (SAS ) has recently been identified as an independent cardiovascular risk factor ,involved in numerous diseases The aim of our study is to evaluate the prevalence and physiopathologic links of SAS in patients with retinal vein occlusion (RVO).Methods Prospective study including 35 patients. Each patient had a simplified screening questionary, and an ambulatory respiratory nocturnal events measurement using the device RU‐sleeping© (Philips Respironics,Inc.).Ventilatory polysomnography (VPS), reference method, is associated in all cases.Results Mean age of patients was 73.6 year, the sex ratio of 1.4 and CRVO as many as BRVO. Glaucoma was found in 31% of patients, hypertension in 52%. Signs of SAS were noted in 95% of patients. The prevalence of severe SAS detected by RU‐sleeping© is 84%, it is significantly higher than that of the population over 60 years (25%) (p <0.001). Preliminary results of VPS are very interesting : they found a strong linear correlation between initial macular thickness evalued by SD OCT(590 +/‐ 170μm ) and results of Apnea‐Hypopnea Index (r=0.88, p=0.004), Arousal Index (r=0.74, p=0.035) and Oxygen Desaturation Index (r=0.58, p=0.027) . Side effects of SAS could explain the occurrence of RVO. RVO could be a consequence of a slow‐down of blood flow circulation secondary to hypoxemia, elevated nocturnal intracranial pressure and rheologic variations in SAS. Arousals cause an additional acute increase in arterial blood pressure and heart rate.Conclusion The results of this preliminary study show a high prevalence of severe SAS in the RVO population. The benefit of early ventilation on prognosis post‐RVO is still unknown. RU‐sleeping© is a simple medical device, which seems interesting for screening SAS ambulatory.