Research status and prospect of obstructive sleep apnea and retinopathy

DONG Meng-lu; FENG Yuan

doi:10.13820/j.cnki.gdyx.20224618

Abstract：Obstructive sleep apnea(OSA)syndrome is a common sleep disorder characterized by chronic inter-mittent hypoxia.It serves as the"primary disease"for various chronic conditions such as type 2 diabetes mellitus(T2DM),hypertension,and cardiovascular diseases.OSA exhibits high heterogeneity,not only in its multifactorial etiol-ogy and diverse mechanisms but also in the individual differences in complications and intricate interactions.Therefore,accurate diagnosis and treatment of OSA patients are crucial,requiring stratification based not only on clinical manifesta-tions and predisposing factors but also on precise attribution of target organ damage and accurate prediction of complica-tions'prognosis.The retinal fundus,being one of the tissues with high oxygen consumption and sensitivity to hypoxia,har-bors vital blood vessels and nerves susceptible to hypoxic damage.It serves as a direct"window"for monitoring the occur-rence and progression of diseases.OSA may lead to direct and indirect damage to the retina and choroid through various mechanisms such as hypoxia,oxidative stress,inflammation,and endothelial injury.This weakens the autoregulation abil-ity of retinal vessels and optic nerves,leading to retinal pathology at different stages of the disease and in different individ-uals,including both acute blinding retinal neurovascular diseases and chronic progressive retinal changes.This article re-views the current clinical and research status of the retina as a target organ in OSA and prospects the role of retinal imaging as a biomarker under new detection technologies,facilitating the assessment of OSA risk,screening for OSA-related com-plications,and achieving precise stratified intervention and prevention.