XU Yunpeng 1 , SHI Peidong 2 , JIANG Ziyi 2 , ZHANG Lei 1 , LEI Xunwen 3 , WU Fanqi 4 , GUO Hong 5 , LIU Jian 1,6
  • 1. The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
  • 2. The Second Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
  • 3. Department of Ophthalmology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
  • 4. Department of Pulmonary and Critical Care Medicine, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
  • 5. Intensive Care Unit, Gansu Province Maternity and Child-Care Hospital (Gansu Provincial Central Hospital), Lanzhou, Gansu 730070, P. R. China;
  • 6. Gansu Province Maternity and Child-Care Hospital (Gansu Provincial Central Hospital), Lanzhou, Gansu 730070, P. R. China;
LIU Jian, Email: medecinliujian@163.com
Obstructive sleep apnea; optical coherence tomography angiography; meta-analysis
10.7507/1671-6205.202406046
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Objective  To evaluate the application value of optical coherence tomography angiography (OCTA) in obstructive sleep apnea syndrome (OSAS). Methods  A comprehensive search of both domestic and international databases was conducted to identify clinical studies on the use of OCTA in OSAS, from the establishment of the databases to May 2024. A meta-analysis was performed using Revman 5.4 software. Results  A total of 134 studies were initially identified, with 14 studies meeting the inclusion criteria, encompassing 999 subjects (739 in the OSAS group and 260 in the healthy group). Meta-analysis results indicated that the superficial capillary plexus (SCP) density in the fovea (MD=–2.05, 95%CI –3.75 to –0.35, P=0.02) and parafovea (MD=–1.56, 95%CI –2.44 to –0.68, P=0.000 5) was significantly lower in the OSAS group compared with the healthy group. In the mild to moderate OSAS group, SCP density was significantly lower in the fovea (MD=–2.41, 95%CI –4.32 to –0.49, P=0.01), parafovea (MD=–1.17, 95%CI –2.01 to –0.32, P=0.007), and perifovea (MD=–1.73, 95%CI –2.69 to –0.77, P=0.000 4) compared with the healthy group. In the severe OSAS group, SCP density in the perifovea (MD=–1.33, 95%CI –2.53 to –0.13, P=0.03) was significantly lower than that of the healthy group. SCP density in the whole area (MD=0.36, 95%CI 0.05 to 0.68, P=0.02) was significantly higher in the mild to moderate OSAS group compared with the severe OSAS group. In the deep capillary plexus (DCP) density, the OSAS group showed significantly lower densities in the whole area (MD=–2.16, 95%CI –3.51 to –0.81, P=0.002), fovea (MD=–2.38, 95%CI –4.38 to –0.37, P=0.02), and parafovea (MD=–2.33, 95%CI –3.93 to –0.73, P=0.004) compared with the healthy group. The mild to moderate OSAS group also showed significantly lower densities in the whole area (MD=–2.02, 95%CI –3.33 to –0.72, P=0.002) and parafovea (MD=–1.65, 95%CI –3.04 to –0.26, P=0.02) compared with the healthy group. The severe OSAS group had significantly lower DCP density in the whole area (MD=–2.26, 95%CI –3.85 to –0.66, P=0.006) and parafovea (MD=–1.47, 95%CI –2.31 to –0.62, P=0.000 7) compared with the healthy group. DCP density in the whole area (MD=0.54, 95%CI 0.02 to 1.07, P=0.04) was significantly higher in the mild to moderate OSAS group compared with the severe OSAS group. Regarding the retinal nerve fiber layer (RNFL) thickness, the inferior quadrant (MD=4.01, 95%CI 0.69 to 7.32, P=0.02) and temporal quadrant (MD=4.35, 95%CI 1.88 to 6.82, P=0.000 6) were significantly thicker in the mild to moderate OSAS group compared with the severe OSAS group. In terms of the foveal avascular zone (FAZ) area, the severe OSAS group showed a significantly larger FAZ area (MD=0.06, 95%CI 0.03 to 0.08, P<0.000 01) compared with the healthy group. Conclusion  OCTA-related ocular biomarkers may be associated with the occurrence and progression of OSAS and have potential applications in the diagnosis and treatment of OSAS.

Citation： XU Yunpeng, SHI Peidong, JIANG Ziyi, ZHANG Lei, LEI Xunwen, WU Fanqi, GUO Hong, LIU Jian. Retinal vascular characteristics in patients with obstructive sleep apnea syndrome assessed by optical coherence tomography angiography: a meta-analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2025, 24(3): 157-166. doi: 10.7507/1671-6205.202406046 Copy

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