|Year : 2021 | Volume
| Issue : 4 | Page : 825-826
Obstructive sleep apnea: Possible risk factor for recurrent retinal vein occlusion
Anamika Patel, Avinash Pathengay, Bhavik Panchal
Vitreoretina and Uveitis Services, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India
|Date of Submission||09-Oct-2020|
|Date of Acceptance||24-Mar-2021|
|Date of Web Publication||09-Oct-2021|
Dr. Anamika Patel
Vitreoretina and Uveitis Services, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam - - 530 040, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
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 18];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|
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| Discussion|| |
Three possible factors for the occurrence of RVO in OSA are hypoxia, hypercapnia, and activation of the sympathetic nervous system. The occurrence of vein occlusion in OSA is known 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|| |
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