Influence of continuous positive airway pressure on optic nerve head vascularization in patients with severe obstructive sleep apnea syndrome: an OCT-angiography study

Objective : To evaluate the influence of continuous positive airway pressure (CPAP) on the vascularization of the optic nerve head using optical coherence tomography angiography (OCT-A) in patients with severe obstructive sleep apnea syndrome (OSAS) naïve to any treatment. Patients and methods : Vascularization of the optic nerve head in the right eye of 22 patients with severe OSAS naïve to any treatment was assessed using OCT-A with AngioPlex® software (Carl Zeiss Meditec, Dublin, CA, USA). All patients underwent a comprehensive ophthalmological examination as well as OCT-A analysis of the radial peripapillary capillary (RPC) and macular superficial capillary plexus (SCP) vascular density (VD). Measurements were taken before and after three months of CPAP treatment. Results : After 3 months of CPAP treatment, total RPC vascular density significantly increased (44.65 ± 1.83 versus 45.70 ± 1.51, P = 0.04). Additionally, a positive correlation was found between the average nightly CPAP usage duration and the increase in RPC vascular density (P = 0.001, r = 0.65, 95% CI [0.14; 1.15]). Conclusion : CPAP may improve vascular density at the optic nerve head in patients with severe OSAS. Our study provides new insights into the potential vascular impact of OSAS on optic nerve vascularization.