Analysis of corneal topographic and endothelial cell properties in newly diagnosed obstructive sleep apnea patients: A case-control study

• Published in: Photodiagnosis and photodynamic therapy Vol. 43; p. 103593
• Main Authors: Yener, Neslihan Parmak, Güneş, Aygül, Yıldız, Demet
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2023
• Subjects: Corneal endothelial cell; Corneal topography; Keratoconus; Obstructive sleep apnea; Specular microscopy; Keratoconus; Obstructive sleep apnea; Specular microscopy; Corneal endothelial cell; Corneal topography
• ISSN: 1572-1000; 1873-1597
• DOI: 10.1016/j.pdpdt.2023.103593

•It has been shown that there are structural changes in the cornea in obstructive sleep apnea (OSA), including keratoconus and corneal endothelial abnormality.•This study showed abnormal changes in corneal endothelial morphology in OSA depending on the severity of the disease. Another remarkable feature of this study is that topographic keratoconus indicators are related to body mass index as well as OSA severity.•It should be kept in mind that keratoconus and endothelial abnormalities may occur as the disease severity and body mass index increase in patients with OSA who are planned for anterior segment surgery such as cataract and refractive surgery. To investigate the topographic features and endothelial cell changes in the corneas of patients with newly diagnosed obstructive sleep apnea (OSA). This cross-sectional case-control study included 98 patients with OSA and 90 healthy controls. OSA was diagnosed on the basis of a polysomnographic sleep examination. Patients with OSA were grouped according to their apnea-hypopnea index (AHI) scores. Corneal topographic measurements were obtained using the Scheimpflug–Placido disk topographer, and keratometry values, anterior chamber parameters, thinnest corneal thickness, symmetry index (SI), keratoconus vertex (KV), and the Baiocchi-Calossi-Versaci index, including keratoconus (KC) screening indexes, were recorded. The corneal endothelium was visualizedby specular microscopy, and the endothelial cell density, coefficient of variability (CV), and percentage of hexagonal cells (HEX) were recorded. In this study, 32 patients had mild, 34 patients had moderate, and 32 patients had severe OSA. The mean back KV (KVb) and back SI values were significantly higher in the OSA group than in the control group (P <0.001, P = 0.035, respectively). As body mass index (BMI) increased, KVb also increased significantly (r = 0.281; P = 0.009). The mean CV and HEX values differed significantly between the OSA and control groups (P = 0.012 and P = 0.002, respectively). In addition, a significant correlation was found between AHI and KVb and CV values (r = 0.315; P <0.001 and r = 0.231; P = 0.011, respectively). This study revealed abnormal changes in the corneal endothelial morphology and topographic KC screening indexes in relation to OSA severity in patients and controls. Further research is required to determine the effect of BMI on corneal topographic findings in patients with OSA.