• Users Online: 154
  • Print this page
  • Email this page


 
 Table of Contents  
PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 4  |  Page : 825-826

Obstructive sleep apnea: Possible risk factor for recurrent retinal vein occlusion


Vitreoretina and Uveitis Services, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India

Date of Submission09-Oct-2020
Date of Acceptance24-Mar-2021
Date of Web Publication09-Oct-2021

Correspondence Address:
Dr. Anamika Patel
Vitreoretina and Uveitis Services, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam - - 530 040, Andhra Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3211_20

Rights and Permissions
  Abstract 


Keywords: Obstructive sleep apnea, OSA, recurrence, retinal vein occlusion


How to cite this article:
Patel A, Pathengay A, Panchal B. Obstructive sleep apnea: Possible risk factor for recurrent retinal vein occlusion. Indian J Ophthalmol Case Rep 2021;1:825-6

How to cite this URL:
Patel A, Pathengay A, Panchal B. Obstructive sleep apnea: Possible risk factor for recurrent retinal vein occlusion. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Oct 26];1:825-6. Available from: https://www.ijoreports.in/text.asp?2021/1/4/825/327665



A 59-year-old known hypertensive man was diagnosed to have right eye (RE) central retinal vein occlusion (RVO) with macular edema (ME) and he was on monthly intravitreal ranibizumab (0.5 mg/0.05 mL) for 3 months [Figure 1]a and [Figure 1]b. Three months after the third injection, his visual acuity had dropped from 20/25 N6 to 20/800 N36 and he was diagnosed with RE superior hemiretinal vein occlusion with ME [Figure 1]c and was treated with intravitreal bevacizumab (1.25 mg/0.05 mL). Given the recurrence of vein occlusion, daytime sleepiness and history of snoring were elicited. The patient was referred to the pulmonologist to rule out obstructive sleep apnea (OSA). The sleep study showed raised apnea-hypopnea index (AHI = 23), risk indicator = 25 and oxygen desaturation index = 27, and the patient was diagnosed with OSA and was initiated on continuous positive airway pressure therapy. Eventually, his visual acuity improved to 20/60, N6 with the resolution of RVO and ME [Figure 1]d after a total of 4 intravitreal injections and remained stable till his last follow-up after one year.
Figure 1: (a) RE fundus photograph (FP) showing central retinal vein occlusion (CRVO) with ME at presentation with corresponding swept-source optical coherence tomography (SS-OCT) (b) RE FP and SS-OCT showing resolved CRVO and ME after 3 monthly dosage of intravitreal ranibizumab. (c) RE FP and SS-OCT showing recurrence of RVO (hemiretinal vein) with ME after 3 months of resolution of vein occlusion and macular edema. (d) RE FP showing resolution of RVO (hemiretinal vein) with ME at last follow-up post intravitreal bevacizumab and continuous positive airway pressure therapy

Click here to view



  Discussion Top


Three possible factors for the occurrence of RVO in OSA are hypoxia, hypercapnia, and activation of the sympathetic nervous system.[1] The occurrence of vein occlusion in OSA is known[2] but recurrence of RVO should also alert the ophthalmologist to rule out OSA.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Hyderabad Eye Research Foundation, Hyderabad, India.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kwon HJ, Kang EC, Lee J, Han J, Song WK. Obstructive sleep apnea in patients with branch retinal vein occlusion: A preliminary study. Korean J Ophthalmology 2016;30:121-6.  Back to cited text no. 1
    
2.
Glacet-Bernard A, Les Jardins GL, Lasry S, Coscas G, Soubrane G, Souied E, et al. Obstructive sleep apnea among patients with retinal vein occlusion. Arch Ophthalmol 2010;128:1533-8.  Back to cited text no. 2
    


    Figures

  [Figure 1]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Discussion
References
Article Figures

 Article Access Statistics
    Viewed54    
    Printed0    
    Emailed0    
    PDF Downloaded8    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]