university of verona eye clinic department of neurological and motor science head: prof. giorgio...
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University of VeronaEye ClinicDepartment of Neurological and Motor ScienceHead: Prof. Giorgio Marchini
Prevalence of Corneal Ectasia in Patients With Obstructive Sleep Apnea: Preliminary Results
Mattia Passilongo, MD, Emilio Pedrotti, MD, Giorgio Marchini MD, Adriano FasoloMattia Passilongo, MD, Emilio Pedrotti, MD, Giorgio Marchini MD, Adriano Fasolo
World Corneal Congress VII – San Diego 15-17 April 2015
The authors have no financial interests to disclose
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The association between Keratoconus and obstructive sleep apnea (OSA)
has been established by several studies, but the converse relationship has
not yet been examined. This study aims to determine the prevalence of
corneal ectasia in a population of patients with OSA.
Purpose
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Retrospective study. We enrolled 178 eyes of 89
patients with diagnosis of OSA. They underwent
polysomnography, ophthalmic clinical examination,
refraction and corneal structure evaluation.
Videokeratographic, aberrometric, and topographic
criteria were applied to identify corneal ectasia.
Likely presence of Keratoconus was defined by
presence of typical ectasia with apical corneal
thinning and subclinical keratoconus by the use of
Calossi-Foggi index (~ Rabinowitz index).
Patients and Methods
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Population: 75 males and 24 females
mean age 64.10+11.78 years
173 normal eye 173 normal eye (none corneal scarring; none slit-lamp signs; typical axial pattern, max corneal power <47 D):
- 104 eyes had a low astigmatism < 1 D
- 69 eyes (39.76%) had a astigmatism > 1 D
5 eyes 5 eyes (2.81%) with ectasia:
- 2 eyes 2 eyes (1,12 %) with Keratoconus (Stage I of Krumeich)
- 3 eyes 3 eyes (1.69%) as subclinical Keratoconus
Best corrected visual acuity 0.03+0.09 in LogMAR
Mean topographic anterior astigmatism 0,96+0,57 D
Mean central corneal pachimetry of 578,06+50.77 um
Results
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Elevated Astitgmatism – example right eye
VA: 20/20 – 0,50 – 1,50 α 10LAF: transparent cornea, transparent lensIOP: 12 mmHgFundus: normal
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Elevated Astitgmatism – example left eye
VA: 20/20 – 2 α 10LAF: transparent cornea, transparent lensIOP: 13 mmHgFundus: normal
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Subclinical Keratoconus – example right eye
VA: 20/20 natLAF: transparent cornea, transparent lensIOP: 12 mmHgFundus: normal
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Subclinical Keratoconus – example left eye
VA: 20/20 + 0,50 sfLAF: transparent cornea, transparent lensIOP: 12 mmHgFundus: normal
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Keratoconus – example right eye (Stage I)
VA: 20/20 – 0,50 α 10LAF: transparent cornea, transparent lensIOP: 12 mmHgFundus: normal
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Keratoconus – example left eye (Stage I)
VA: 20/20 – 0,50 + 1 α 90LAF: transparent cornea, transparent lensIOP: 14 mmHgFundus: normal
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The prevalence of corneal ectasia observed and at least 3 patients of
undiagnosed keratoconus or suspected ectasia may suggest that OSA
patients should be referred to ophthalmologists to have their corneas checked
since the association between OSA and Keratoconus exist.
Conclusions