arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2019-25-6-613-621arthyper-1882Research ArticleСТРАНИЦА СОМНОЛОГАSOMNOLOGIST’S PAGEОбструктивное апноэ в патогенезе сосудистых заболеваний органа зренияObstructive sleep apnea in the pathogenesis of ocular vascular diseaseshttps://orcid.org/0000-0002-7570-2395АстаховЮ. С.AstakhovY. S.

Астахов Юрий Сергеевич — доктор медицинских наук, профессор кафедры офтальмологии

Санкт-Петербург

Yury S. Astakhov, MD, PhD, DSc, Professor, Department of Ophthalmology

St Petersburg

astakhov73@mail.ruhttps://orcid.org/0000-0002-9423-6772ТульцеваС. Н.TultsevaS. N.

Тульцева Светлана Николаевна — доктор медицинских наук, профессор кафедры офтальмологии

Санкт-Петербург

Svetlana N. Tultseva, MD, PhD, DSc, Professor. Department of Ophthalmology

St Petersburg

tultceva@yandex.ruhttps://orcid.org/0000-0002-4081-3423ТитаренкоА. И.TitarenkoA. I.

Титаренко Александра Ивановна — аспирантка кафедры офтальмологии с клиникой

ул. Льва Толстого, д. 6/8, Санкт-Петербург, 197022

Aleksandra I. Titarenko, MD, Post-Graduate Student, Ophthalmology Department

6/8 Lev Tolstoy street, St Petersburg, 197089

aleksandra-titarenko@yandex.ruhttps://orcid.org/0000-0003-0777-4861АстаховС. Ю.AstakhovS. Y.

Астахов Сергей Юрьевич — доктор медицинских наук, профессор кафедры офтальмологии

Санкт-Петербург

Sergei Yu. Astakhov, MD, PhD, DSc, Professor, Department of Ophthalmology

St Petersburg

astakhov73@mail.ruhttps://orcid.org/0000-0003-1107-6214АнтоновВ. А.AntonovV. A.

Антонов Владимир Александрович — аспирант кафедры офтальмологии с клиникой

Санкт-Петербург

Vladimir A. Antonov, MD, Post-Graduate Student, Ophthalmology Department

St Petersburg

antonov@alborada.fiИонинВ. А.IoninV. A.

Ионин Валерий Александрович — кандидат медицинских наук, доцент кафедры факультетской терапии с клиникой

Санкт-Петербург

Valeriy A. Ionin, MD, PhD, Assistant Professor, Department of Internal Diseases #2

St Petersburg

ionin.v.a@gmail.comhttps://orcid.org/0000-0001-9746-7552ОвнанянА. Ю.OvnanyanA. Y.

Овнанян Андроник Юраевич — врач-офтальмолог кафедры офтальмологии с клиникой

Санкт-Петербург

Andronik Yu. Ovnanyan, MD, Ophthalmologist, Department of Ophthalmology

St Petersburg

ovnanyan@yandex.ruНовиковС. А.NovikovS. A.

Новиков Сергей Александрович — доктор медицинских наук, профессор, кафедра офтальмологии с клиникой

Санкт-Петербург

Sergey A. Novikov, MD, PhD, DSc, Professor, Ophthalmology Department

St Petersburg

serg2705@yandex.ruГосударственное бюджетное образовательное учреждение высшего профессионального образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияPavlov UniversityRussian Federation201913122019256613621Copyright © Астахов Ю.С., Тульцева С.Н., Титаренко А.И., Астахов С.Ю., Антонов В.А., Ионин В.А., Овнанян А.Ю., Новиков С.А., 20202020Астахов Ю.С., Тульцева С.Н., Титаренко А.И., Астахов С.Ю., Антонов В.А., Ионин В.А., Овнанян А.Ю., Новиков С.А.Astakhov Y.S., Tultseva S.N., Titarenko A.I., Astakhov S.Y., Antonov V.A., Ionin V.A., Ovnanyan A.Y., Novikov S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1882

Респираторные нарушения, обусловленные синдромом обструктивного апноэ во время сна (СОАС), увеличивают риск развития сосудистых заболеваний органа зрения. Сопутствующие СОАС гипоксия, гиперкапния, эндотелиальная дисфункция способствуют локальному нарушению фибринолиза, вызывают гиперкоагуляцию и вазоспазм, создавая условия для возникновения окклюзий как вен сетчатки, так и задних цилиарных артерий. У 91,5 % пациентов с окклюзией вен сетчатки и у 75 % пациентов с неартериитной формой передней ишемической нейрооптикопатии выявляется СОАС средней и тяжелой степени. Своевременные диагностика и лечение СОАС являются профилактикой развития острой сосудистой патологии сетчатки и зрительного нерва.

Respiratory changes caused by obstructive sleep apnea (OSA) syndrome increase the risk of ocular vascular diseases. Hypoxia, hypercapnia, endothelial dysfunction associated with OSA syndrome, promote local impairment of fibrinolysis, cause hypercoagulation and vasospasm, creating conditions for retinal vein occlusions as well as for those of posterior ciliary arteries. 91,5 % patients with retinal vein occlusions and 75 % patients with nonarteritic anterior ischemic optic neuropathy have moderate-to-severe OSA. OSA timely diagnosis and treatment prevent acute vascular pathology of the retina and optic nerve.

синдром обструктивного апноэ во время снаокклюзия вен сетчаткипередняя ишемическая нейрооптикопатиянеоваскуляризацияobstructive sleep apnea syndromeretinal vein occlusionanterior ischemic optic neuropathyneovascularizationReferencesBerry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med. 2012;8(5):597–619. doi: 10.5664/jcsm.2172Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med. 2012;8(5):597–619. doi: 10.5664/jcsm.2172Пальман А. Д. Синдром обструктивного апноэ во сне в клинике внутренних болезней. Под ред. А. И. Синопальникова. М., 2007. 77 с.Palman AD. Sleep apnea syndrome in the clinic of internal diseases. Edited by A. I. Sinopalnikov. M., 2007. 77 p. In Russian.Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP. Pathophysiology of sleep apnea. Physiol Rev. 2010;90(1):47–112. doi: 10.1152/physrev.00043.2008Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP. Pathophysiology of sleep apnea. Physiol Rev. 2010;90(1):47–112. doi: 10.1152/physrev.00043.2008Carmelli D, Swan GE, Bliwise DL. Relationship of 30-year changes in obesity to sleep-disordered breathing in the Western Collaborative Group Study. Obes Res. 2000;8(9):632–637. doi: 10.1038/oby.2000.81Carmelli D, Swan GE, Bliwise DL. Relationship of 30-year changes in obesity to sleep-disordered breathing in the Western Collaborative Group Study. Obes Res. 2000;8(9):632–637. doi: 10.1038/oby.2000.81Semelka M, Wilson J, Floyd R. Diagnosis and treatment of obstructive sleep apnea in adults. Am Fam Physician. 2016;94(5): 355–360.Semelka M, Wilson J, Floyd R. Diagnosis and treatment of obstructive sleep apnea in adults. Am Fam Physician. 2016;94(5): 355–360.Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea? The rational clinical examination systematic review. J Am Med Assoc. 2013;310(7):731–741. doi: 10.1001/jama.2013.276185Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea? The rational clinical examination systematic review. J Am Med Assoc. 2013;310(7):731–741. doi: 10.1001/jama.2013.276185Balachandran JS, Patel SR. In the clinic: obstructive sleep apnea. Ann Intern Med. 2014;161(9): ITC1–15. doi: 10.7326/00034819-161-9-201411040-01005Balachandran JS, Patel SR. In the clinic: obstructive sleep apnea. Ann Intern Med. 2014;161(9): ITC1–15. doi: 10.7326/00034819-161-9-201411040-01005Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol. 1983;52(5):490–494. doi: 10.1016/0002-9149(83)90013-9Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol. 1983;52(5):490–494. doi: 10.1016/0002-9149(83)90013-9Young T, Finn L, Peppard PE. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008;31(8):1071–1078. doi: 10.5665/sleep/31.8.1071Young T, Finn L, Peppard PE. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008;31(8):1071–1078. doi: 10.5665/sleep/31.8.1071Волов Н. А., Шайдюк О. Ю., Таратухин Е. О. Синдром ночного апноэ и факторы риска сердечно-сосудистой патологии. Российский кардиологический журнал. 2008;71(3):65–70. doi: 10.15829/1560-4071-2008-3-65-70Volov NA, Shaydyuk OY, Taratukhin EO. Sleep apnea syndrome and cardiovascular risk factors. Russ J Cardiol. 2008;71(3):65–70. doi: 10.15829/15604071-2008-3-65-70. In Russian.Huon L, Liu SY, Camacho M, Guilleminault C. The association between ophthalmologic diseases and obstructive sleep apnea: a systemic review and meta-analysis. Sleep Breath. 2016;20 (4):1145–1154. doi: 10.1007/s11325-016-1358-4Huon L, Liu SY, Camacho M, Guilleminault C. The association between ophthalmologic diseases and obstructive sleep apnea: a systemic review and meta-analysis. Sleep Breath. 2016;20 (4):1145–1154. doi: 10.1007/s11325-016-1358-4Fraser CL. Obstructive sleep apnea and optic neuropathy. Is there a link? Curr Neurol Neurosci Rep. 2014;14(8):465–470. doi: 10.1007/s11910-014-0465-5Fraser CL. Obstructive sleep apnea and optic neuropathy. Is there a link? Curr Neurol Neurosci Rep. 2014;14(8):465–470. doi: 10.1007/s11910-014-0465-5Chou K, Huang C, Tsai D, Chen Y, Perng D, Shiao GM et al. Speep apnea and risk of retinal vein occlusion: a nationwide population-based study of Taiwanese. Am J Ophthalmol. 2012;154 (1):200–205. doi: 10.1016/j.ajo.2012.01.011Chou K, Huang C, Tsai D, Chen Y, Perng D, Shiao GM et al. Speep apnea and risk of retinal vein occlusion: a nationwide population-based study of Taiwanese. Am J Ophthalmol. 2012;154 (1):200–205. doi: 10.1016/j.ajo.2012.01.011Agard E, Chebab HE, Vie A, Voirin N, Coste O, Dot C. Retinal vein occlusion and obstructive sleep apnea: a series of 114 patients. Acta Ophthalmol. 2018;96(8):919–925. doi: 10.1111/aos.13798Agard E, Chebab HE, Vie A, Voirin N, Coste O, Dot C. Retinal vein occlusion and obstructive sleep apnea: a series of 114 patients. Acta Ophthalmol. 2018;96(8):919–925. doi: 10.1111/aos.13798Sun MH, Liao YJ, Lin CC, Chiang RP, Wei JC. Association between obstructive sleep apnea and optic neuropathy: a Taiwanese population-based cohort study. Eye (Lond). 2018;32(8):1353–1358. doi: 10.1038/s41433-018-0088-1Sun MH, Liao YJ, Lin CC, Chiang RP, Wei JC. Association between obstructive sleep apnea and optic neuropathy: a Taiwanese population-based cohort study. Eye (Lond). 2018;32(8):1353–1358. doi: 10.1038/s41433-018-0088-1Gaier ED, Torun N. The enigma of nonarteritic anterior ischemic optic neuropathy: an update for the comprehensive ophthalmologist. Curr Opin Ophthalmol. 2016;27(6):498–504. doi: 10.1097/ICU.0000000000000318Gaier ED, Torun N. The enigma of nonarteritic anterior ischemic optic neuropathy: an update for the comprehensive ophthalmologist. Curr Opin Ophthalmol. 2016;27(6):498–504. doi: 10.1097/ICU.0000000000000318Aptel F, Khayi H, Pépin JL, Tamisier R, Levy P, Romanet JP et al. Association of nonarteritic ischemic optic neuropathy with obstructive sleep apnea syndrome: consequences for obstructive sleep apnea screening and treatment. JAMA Ophthalmol. 2015;133 (7):797–804. doi: 10.1001/jamaophthalmol.2015.0893Aptel F, Khayi H, Pépin JL, Tamisier R, Levy P, Romanet JP et al. Association of nonarteritic ischemic optic neuropathy with obstructive sleep apnea syndrome: consequences for obstructive sleep apnea screening and treatment. JAMA Ophthalmol. 2015;133 (7):797–804. doi: 10.1001/jamaophthalmol.2015.0893Lesske J, Fletcher EC, Bao G, Unger T. Hypertension caused by chronic intermittent hypoxia-influence of chemoreceptors and sympathetic nervous system. J Hypertens. 1997;15(12Pt2):15931603. doi: 10.1097/00004872-199715120-00060Lesske J, Fletcher EC, Bao G, Unger T. Hypertension caused by chronic intermittent hypoxia-influence of chemoreceptors and sympathetic nervous system. J Hypertens. 1997;15(12Pt2):15931603. doi: 10.1097/00004872-199715120-00060Seif F, Patel SR, Walia H, Rueschman M, Bhatt DL, Gottlieb DJ et al. Association between obstructive sleep apnea severity and endothelial dysfunction in an increased background of cardiovascular burden. J Sleep Res. 2013;22(4):443–451. doi: 10.1111/jsr.12026Seif F, Patel SR, Walia H, Rueschman M, Bhatt DL, Gottlieb DJ et al. Association between obstructive sleep apnea severity and endothelial dysfunction in an increased background of cardiovascular burden. J Sleep Res. 2013;22(4):443–451. doi: 10.1111/jsr.12026Wong B, Fraser CL. Obstructive sleep apnea in neuroophthalmology. J Neuroophthalmology. 2019;39(3):370–379. doi: 10.1097/WNO.0000000000000728Wong B, Fraser CL. Obstructive sleep apnea in neuroophthalmology. J Neuroophthalmology. 2019;39(3):370–379. doi: 10.1097/WNO.0000000000000728Ohana EB, Blumen MB, Bluwol E, Derri M, Chabolle F, Nordmann JP. Primary open angle glaucoma and snoring: prevalence of OSAS. Eur Ann Otorhinolaryngol Head Neck Dis. 2010;127(5):159–164. doi: 10.1016/j.anorl.2010.07.003Ohana EB, Blumen MB, Bluwol E, Derri M, Chabolle F, Nordmann JP. Primary open angle glaucoma and snoring: prevalence of OSAS. Eur Ann Otorhinolaryngol Head Neck Dis. 2010;127(5):159–164. doi: 10.1016/j.anorl.2010.07.003Johns MW. A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep. 1991;14 (6):540–545 [Electronic resource]. URL: https://nasemso.org/wpcontent/uploads/neuro-epworthsleepscale.pdfJohns MW. A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep. 1991;14 (6):540–545 [Electronic resource]. URL: https://nasemso.org/wpcontent/uploads/neuro-epworthsleepscale.pdf[Electronic resource]. URL: https://www.sleepapnea.org/wp-content/uploads/2017/02/berlin-questionnaire.pdf[Electronic resource]. URL: https://www.sleepapnea.org/wp-content/uploads/2017/02/berlin-questionnaire.pdfChiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate metaanalysis. Sleep Med Rev. 2017;36:57–70. doi: 10.1016/j.smrv.2016.10.004Chiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate metaanalysis. Sleep Med Rev. 2017;36:57–70. doi: 10.1016/j.smrv.2016.10.004Kim RD, Kapur VK, Redline-Bruch J, Rueschman M, Auckley DH, Benca RM et al. An economic evaluation of home versus laboratory-based diagnosis of obstructive sleep apnea. Sleep. 2015;38(7):1027–1037. doi: 10.5665/sleep.4804Kim RD, Kapur VK, Redline-Bruch J, Rueschman M, Auckley DH, Benca RM et al. An economic evaluation of home versus laboratory-based diagnosis of obstructive sleep apnea. Sleep. 2015;38(7):1027–1037. doi: 10.5665/sleep.4804Lee RWW, Petocz P, Prvan T, Chan ASL, Grunstein RR, Cistulli PA. Prediction of obstructive sleep apnea with craniofacial photographic analysis. Sleep. 2009;32(1):46–52. doi: 10.5665/sleep/32.1.46Lee RWW, Petocz P, Prvan T, Chan ASL, Grunstein RR, Cistulli PA. Prediction of obstructive sleep apnea with craniofacial photographic analysis. Sleep. 2009;32(1):46–52. doi: 10.5665/sleep/32.1.46Kwon HJ, Kang EC, Lee J, Han J, Song WK. Obstructive sleep apnea in patients with branch retinal vein occlusion: A Preliminary Study. Korean J Ophthalmol. 2016;30(2):121–126. doi: 10.3341/kjo.2016.30.2.121Kwon HJ, Kang EC, Lee J, Han J, Song WK. Obstructive sleep apnea in patients with branch retinal vein occlusion: A Preliminary Study. Korean J Ophthalmol. 2016;30(2):121–126. doi: 10.3341/kjo.2016.30.2.121Boyd SR, Zachary I, Chakravarthy U, Allen GJ, Wisdom GB, Cree IA et al. Correlation of increased vascular endothelial growth factor with neovascularization and permeability in ischemic central vein occlusion. Arch Ophthalmol. 2002;120(12):1644–1650. doi: 10.1001/archopht.120.12.1644Boyd SR, Zachary I, Chakravarthy U, Allen GJ, Wisdom GB, Cree IA et al. Correlation of increased vascular endothelial growth factor with neovascularization and permeability in ischemic central vein occlusion. Arch Ophthalmol. 2002;120(12):1644–1650. doi: 10.1001/archopht.120.12.1644Zhang XB, Jiang XT, Cai FR, Zeng HQ, Du YP. Vascular endothelial growth factor levels in patients with obstructive sleep apnea: a meta-analysis. Eur Arch Otorhinolaryngol. 2017;274 (2):661–670. doi: 10.1007/s00405-016-4102-6Zhang XB, Jiang XT, Cai FR, Zeng HQ, Du YP. Vascular endothelial growth factor levels in patients with obstructive sleep apnea: a meta-analysis. Eur Arch Otorhinolaryngol. 2017;274 (2):661–670. doi: 10.1007/s00405-016-4102-6Choi JB, Loredo JS, Norman D, Mills PJ, Ancoli-Israel S, Ziegler MG et al. Does obstructive sleep apnea increase hematocrit? Sleep Breath. 2006;10(3):155–160. doi: 10.1007/s11325-0060064-zChoi JB, Loredo JS, Norman D, Mills PJ, Ancoli-Israel S, Ziegler MG et al. Does obstructive sleep apnea increase hematocrit? Sleep Breath. 2006;10(3):155–160. doi: 10.1007/s11325-0060064-zQi JC, Zhang L, Li H, Zeng H, Ye Y, Wang T et al. Impact of continuous positive airway pressure on vascular endothelial growth factor in patients with obstructive sleep apnea: a meta-analysis. Sleep Breath. 2019;23(1):5–12. doi: 10.1007/s11325-018-1660-4Qi JC, Zhang L, Li H, Zeng H, Ye Y, Wang T et al. Impact of continuous positive airway pressure on vascular endothelial growth factor in patients with obstructive sleep apnea: a meta-analysis. Sleep Breath. 2019;23(1):5–12. doi: 10.1007/s11325-018-1660-4Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med. 2012;8(5):597–619.Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med. 2012;8(5):597–619.

The authors declare that there are no conflicts of interest present.