Tekeli, OyaAbdullavey, Ahmet2022-06-072022-06-072015http://hdl.handle.net/20.500.12575/81235İnvestigation of glaucomotous changes in patients with obstuctive sleep apnea syndrome (OSAS) Method: Fifty nine patients, who were diagnosed with OSAS due to apnea-hypopnea index (AHI) using polysomnography in the sleep laboratory of Ankara University Faculty of Medicine, Department of Chest Diseases, and 19 controls were included in study. In these patients, between December 2012 and May 2015 at the Ankara University Faculty of Medicine, Department of Ophthalmology, the presence of glaucoma was investigated. According to AHI scores OSAS patients divided in 3 groups; with the AHI scores between 5-15 patients were considered in the mild OSAS group, with the AHI scores between 16-30 patients were considered in the moderate OSAS group and with the AHI scores over 30 patients were considered in the severe OSAS group. According to these classification; 37 eyes of 19 patients in the mild group, 31 eyes of 16 patients with moderate and 47 eyes of 24 patients were enrolled in the severe group. Thirthy eight eyes of 19 healthy subjects were included in the study as a control group. All participants, underwent a complete ophthalmologic evaluation, including pachymetry, visual field, optical coherence tomography (retinal nerve fiber layer, ganglion cells and the optic nerve head analysis) tests. Results: Total 154 eyes of 78 patients included in this study. There were 34 male, 25 female in the OSAS group and 6 male and 13 female subjects in the control group. The mean age of OSAS groups were 56.63±7.93 (mild OSAS), 55.63±6.03 (modarete OSAS) and 55.67±9.5 (severe OSAS) years. The mean age of the control group was 52.58±6.17 years. There was no statistically significant difference between groups in term of age (p>0.05). Four eyes of 2 patients had ocular hypertension and both of these patients had severe OSAS (%3.44). Between mild, modarate and severe OSAS patients and control group, there was no statistical significant difference in the intraocular pressure (IOP), best corrected visual acuity (BCVA), mean retinal nerve fiber layer (RNFL), optic nerve head (ONH) parameters and mean deviation (MD) (p>0.05). There was a positive correlation between RNLF and AHI scores in left eyes of intermediate OSAS patients (p=0.010, r=0.620). Compared to the control group, pattern standard deviation (PSD) values have been significantly higher in the mild OSAS group in the right eye and significantly higher in the modarate OSAS group in the left eye (p=0.025, p=0.033 respectively). Regarding average ganglion cell complex (GCC) thickness, It was found to be significantly lower in mild OSAS group than the control group (p=0.013). Minimum ganglion cell complex (MGHK) in the left eye, were found to be significantly lower than the control group in mild, moderate and severe OSAS group (p=0.010, p=0.019, p=0.004 respectively). There was no relationship between the average and the minimum GCC with AHI. In the left eyes of whole OSAS patients, central corneal thickness (CCT) was lower than control group with a statistical significant difference (p=0.040). When all OSAS patients were evaluated, any statistical correlation was not detected between AHI and mean CCT, BCVA, optic nevre analyses and MD. There was a positive correlation between intraocular pressure (İOP) and AHI scores in right eyes of whole OSAS patients (p=0.041, r=0.272). Conclusion: OSAS may be a risk factor for glaucoma. Changes in the ganglion cell complex and retinal nerve fiber layer thickness may precedes visual fields changes in OSAS patients.trObstrüktifGlokomdoctoralThesis