Abstract
Objective
To evaluate the prevalence and varying severity of obstructive sleep apnea (OSA) amongst
those newly diagnosed with retinal vein occlusion (RVO), and screen patients with
the use of 2 in-office-administered questionnaires validated against polysomnography.
Design
Prospective cross-sectional study.
Participants
Consecutive adult patients (≥18 years of age) with a new diagnosis of RVO confirmed
with intravenous fluorescein angiography were enrolled.
Methods
The study was conducted at a tertiary academic centre between March 22, 2017, and
April 7, 2018. Patients completed the Berlin and STOP-BANG questionnaires screening
for OSA at presentation. Diagnostic test properties of the 2 questionnaires compared
with polysomnography at a certified sleep laboratory centre as the gold standard for
detection of OSA were calculated.
Results
A total of 27 patients (37% females) with a mean (standard deviation) age of 69.6
(11.5) years completed the study. The diagnosis of OSA based on polysomnography was
made in 96% (41% severe OSA) of patients with RVO. The Berlin questionnaire had a
sensitivity of 43% (confidence interval [CI]: 22%–66%) and specificity of 67% (CI:
22%–96%). The STOP-BANG questionnaire had a sensitivity of 86% (CI: 64%–97%) and specificity
of 50% (CI: 12%–88%).
Conclusions
Given the high prevalence of severe OSA amongst those with a new diagnosis of RVO,
all patients should be strongly considered for polysomnography. The use of in-office
questionnaires may aid in triaging urgency of referrals.
Résumé
Objectif
Évaluer la prévalence et le degré de gravité de l'apnée obstructive du sommeil (AOS)
chez des patients qui viennent de faire l'objet d'un diagnostic d'occlusion veineuse
rétinienne (OVR) et assurer le dépistage de l'AOS à l'aide de 2 questionnaires validés
par polysomnographie et administrés au bureau du médecin.
Nature
Étude transversale prospective.
Participants
Ont été admis des patients consécutifs d’âge adulte (≥ 18 ans) qui venaient de faire
l'objet d'un diagnostic d'OVR confirmée par angiographie à la fluorescéine.
Méthodes
L’étude a été réalisée dans un centre universitaire de soins tertiaires du 22 mars
2017 au 7 avril 2018. Les patients ont répondu au questionnaire de Berlin et au questionnaire
STOP-Bang en vue du dépistage de l'AOS lors de l'examen initial. On a examiné les
propriétés diagnostiques des 2 questionnaires par rapport à celles de la polysomnographie
réalisée dans un laboratoire du sommeil certifié à titre de référence absolue pour
le diagnostic de l'AOS.
Résultats
Un total de 27 patients (37 % de femmes) dont l’âge moyen (± écart-type) était de
69,6 ans (± 11,5 ans) ont pris part à l’étude. Le diagnostic d'AOS obtenu au décours
d'une polysomnographie a été posé chez 96 % des patients (dont 41 % affichaient une
AOS grave) présentant une OVR. Le questionnaire de Berlin avait une sensibilité de
43 % (intervalle de confiance [IC]: 22 %–66 %) et une spécificité de 67 % (IC: 22
%–96 %). Pour sa part, le questionnaire STOP-Bang avait une sensibilité de 86 % (IC:
64 %–97 %) et une spécificité de 50 % (IC: 12 %–88 %).
Conclusions
Compte tenu de la prévalence élevée d'AOS grave chez les patients qui viennent de
recevoir un diagnostic d'OVR, on devrait recommander sérieusement une polysomnographie
à tous les patients. Les questionnaires au bureau du médecin peuvent servir à cerner
les cas urgents.
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Article info
Publication history
Published online: April 18, 2020
Accepted:
March 5,
2020
Received in revised form:
February 29,
2020
Received:
November 30,
2019
Footnotes
Presented at the Canadian Ophthalmological Society Annual Meeting, Quebec Convention Centre, Québec City, Que., June 13–16, 2019.
Identification
Copyright
© 2020 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
