This prospective study aimed to evaluate a relationship between central serous retinopathy (CSR) and obstructive sleep apnoea (OSA). Twenty-three subjects (six female and 17 male) were diagnosed with CSR and overnight polysonography was performed to record desaturation and apnoeic episodes. They found that 60% of patients had some form of OSA (mild, moderate, severe). Both CSR and OSA were seen more frequently in the male subjects and there is known to be a male predominance for both these conditions. The mechanism for this relationship is unknown but the authors suggest that it could result from oxidative stress. OSA is a sleep related disorder where repetitive obstruction of airflow in the upper airway leads to chronic recurrent hypoxia and oxidative stress. They hypothesise two mechanisms that connect the two conditions, the first being that oxidative stress causes choroidal vasoconstriction. Previous studies have shown choroidal circulatory disturbance with indocyanine green angiography in patients with CSR. The second mechanism is increased blood coagulation abnormalities as other studies have shown that levels of plasma activator inhibitor 1 (PAI-1) were increased in patients with both CSR and OSA. OSA is also associated with other ocular conditions such as normal tension glaucoma and also increases the risk of cardiovascular and neuropsychological diseases. If this relationship can be confirmed with further prospective studies, patients presenting with CSR should be screened for OSA and a thorough systemic history should be undertaken.

Obstructive sleep apnoea in patients with central serous chorioretinopathy.
Yavaş GF, Kusbeci T, Kasikci M, et al.
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Khadijah Basheer

Moorfields Eye Hospital, London, UK.

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