OBJECTIVE

A prospective controlled cohort study examined the effects of obstructive sleep apnea syndrome (OSAS) on the visual field, including morphological and physiological aspects.

METHODS

Thirty-two patients with newly discovered and previously untreated moderate to severe OSAS (apnea-hypopnea index >20) were compared with a control group of 32 healthy individuals. Global visual field indices [mean deviation (MD), corrected pattern standard deviation (CPSD)] were compared, and optic disc changes, intraocular pressure, correlations between MD and polysomnography, and the frequency of local defects (using the Humphrey Field Analyzer) were examined.

RESULTS

The MD was significantly reduced (R -1.66/L -1.62 dB; p<0.001) in OSAS patients, whereas there was no difference in CPSD. Diffuse local defects in the middle periphery of the 30° visual field were increased in OSAS patients (p<0.003). Normal intraocular tension values were found in all persons, with no correlation to MD. The incidence of pathological optic disc changes was increased in the apnea group (6.25%).

CONCLUSIONS

OSAS seems to lead to reduced sensitivity in the visual field by diffuse rarefaction of nerve tissue in the retina, optic nerve, or both. An increased incidence of development of a low-tension glaucoma is assumed.