Original articleNocturnal Intermittent Serious Hypoxia and Reoxygenation in Proliferative Diabetic Retinopathy Cases
Section snippets
Methods
A total of 219 Japanese inpatients, who had type 2 diabetes, including 68 consecutive nonproliferative diabetic retinopathy (NPDR) cases and 151 consecutive PDR cases were included in this study. Patients with NPDR underwent vitreous surgery for macular edema or cataract surgery, and those with PDR underwent filtering surgery for neovascular glaucoma or vitreous surgery for macular edema, vitreous hemorrhage, and traction retinal detachment from April 1, 2006, through April 1, 2008, at the
Results
Preoperative patient background factors for the NPDR and PDR groups are shown in Table 1. There were significant differences between the 2 groups in age. The NPDR group was older than the PDR group (mean age ± standard deviation [SD], 65.9 ± 6.6 years [NPDR] vs 59.9 ± 9.9 years [PDR]; P > .0001). Preoperative HbA1c value and frequency of hypertension tended to be higher in the PDR than in the NPDR group (mean HbA1c value ± SD, 7.4 ± 1.5% [PDR] vs 7.1 ± 1.2% [NPDR]; P = .07; mean hypertension
Discussion
The mechanism by which SDB evokes arteriosclerotic diseases is speculated to be as follows. SDB can cause overnight repetitive hypoxemia and reoxygenation, resulting in autonomic hyperactivity that persists until daytime;10, 11 increased serum inflammatory cytokine levels, for example, vascular endothelial growth factor12; greater oxidant stress13; increased emergence of adhesion factors, such as intercellular adhesion molecule 1 and vascular cell adhesion molecule,14 and so on. A vascular
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2021, American Journal of OphthalmologyCitation Excerpt :The association between OSA and diabetes is bidirectional43; OSA is highly prevalent in men with T2DM, and diabetes increased the risk of OSA.44 Furthermore, OSA is highly associated with the development of DR31,33,45-50 and the aggravation of DR.51,52 High OSA severity is independently associated with retinal arteriolar narrowing and attenuated vascular pulsation amplitude,53 which may impair microvascular perfusion of the retina.
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2020, Diabetes Research and Clinical PracticeCitation Excerpt :A cross-sectional study from the United Kingdom reported that OSA defined by ODI had a strong association with DR, independent of conventional retinopathy risk factors [33]. Another cross-sectional study including 68 nonproliferative and 151 proliferative diabetic retinopathy cases showed that 4% ODI was associated with the severity of DR [34]. In our current study, we also observed a significant positive association of ODI with higher odds of having DR adjusted for age and sex.
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Sleep apnea-hypopnea syndrome and type 2 diabetes. A reciprocal relationship?
2015, Archivos de BronconeumologiaCitation Excerpt :Despite some findings to the contrary,148 most studies show an association between SAHS and severity of retinopathy, as well as a higher risk of progression. In a cross-sectional case-control study that included 68 patients with non-proliferative diabetic retinopathy and 151 patients with proliferative diabetic retinopathy, the severity of nocturnal desaturations (evaluated by means of the desaturation index and the minimum SaO2) was a risk factor for proliferative diabetic retinopathy, suggesting that the reoxygenation caused by the SAHS could affect retinopathy progression.149 In another study conducted in men with DM2, SAHS was independently associated with retinopathy and diabetic maculopathy.139