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. 2025 Jun 11:17:1249-1258.
doi: 10.2147/NSS.S493508. eCollection 2025.

Alterations on Microcirculation of Optic Nerve Head Before and After OSA Surgery

Pei-Wen Lin #  1   2   3   4 , Li-Wen Chiu  1 , Chung-Wei Lin  5 , Chun-Tuan Chang  6 , Hsin-Ching Lin #  2   3   4   5   6   7   8
Affiliations

Alterations on Microcirculation of Optic Nerve Head Before and After OSA Surgery

Pei-Wen Lin et al. Nat Sci Sleep. .

Abstract

Objective: Obstructive sleep apnea/hypopnea syndrome (OSA) can compromise oxygenation of the optic nerve and cause glaucomatous optic neuropathy; however, there were no studies to investigate the changes of optic nerve microcirculation in patients with OSA before and after treatment. We conducted the first study to assess whether OSA surgery will change the optic nerve microcirculation in patients with OSA.

Study design: Prospective single-blind study.

Setting: Tertiary medical center.

Methods: The enrolled patients were completed for overnight polysomnography (PSG) and comprehensive ophthalmologic evaluation, including laser speckle flowgraphy (LSFG) for microcirculation of optic nerve head (ONH) before and 3 months after OSA surgery. LSFG measurements were summarized as mean blur rate in all areas (MA), in big vessel area (MV) and in tissue area (MT) of ONH.

Results: Twenty-nine patients underwent upper airway surgery were included. Three months after surgery, 75.9% (22/29) patients, including 15 of 20 patients with severe OSA and 7 of 9 patients with moderate OSA had improvement in apnea/hypopnea index (AHI). The major parameters of PSG significantly improved. Regarding the LSFG parameters, MA (p = 0.023), MV (p = 0.033) and MT (p = 0.026) significantly increased 3 months after surgery. Moreover, there were significant differences in MA (p = 0.035) and MT (p = 0.045) in the AHI-improved subgroup after surgery.

Conclusion: The ONH microcirculation significantly improved in the AHI-improved patients with OSA 3 months after upper airway surgery. Upper airway surgery may ameliorate the ONH microcirculation in patients with OSA.

Keywords: laser speckle flowgraphy; obstructive sleep apnea surgery; obstructive sleep apnea syndrome; optic nerve head microcirculation; snoring.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The color-coded composite map of the optic nerve head (ONH). The elliptical region was set semi-manually at the outer edge of the ONH. The colors represent the time averages of MBR over one heartbeat.
Figure 2
Figure 2
The flowchart of the study participant selection process.
Figure 3
Figure 3
Box plots of MBR parameters for the surgery group. (a) MA, (b) MV, (c) MT. *Statistically significant.
See this image and copyright information in PMC

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