目的：探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)严重程度与前部缺血性视神经病变(AION)患者视野缺损及视觉诱发电位(VEP)参数的相关性。

方法：回顾性病例对照研究。选取2022年6月至2025年10月于徐州医科大学附属徐州市立医院眼科确诊的AION合并OSAHS患者纳入研究。按AHI及mSaO₂分为三组：轻度组AHI每小时5-15次，mSaO₂85%-90%； 中度组AHI每小时16-30次，mSaO₂80%-85%； 重度组AHI每小时>30次，mSaO₂<80%。比较三组患者一般资料、视网膜神经纤维层(RNFL)厚度、视野缺损指标\〖平均缺损(MD)、模式标准差(PSD)\〗及VEP参数(P100波潜伏期、振幅)。

结果：本研究共纳入AION合并OSAHS患者110例，按OSAHS严重程度分为轻度组37例(男21例、女16例，平均年龄62.15±9.37岁)、中度组35例(男20例、女15例，平均年龄61.82±8.94岁)、重度组38例(男22例、女16例，平均年龄63.02±9.61岁)。三组患者年龄、性别、TG、TC、LDL-C、HDL-C水平、AION严重程度比较均无差异(均P>0.05)，高血压病史、糖尿病病史、收缩压、舒张压、FPG水平均有比较差异(均P<0.05)。重度组患者平均RNFL厚度(63.27±5.58 μm)显著低于中度组(74.14±6.28 μm)及轻度组(83.22±7.02 μm)，中度组低于轻度组(均P<0.05)； 重度组MD值(-11.57±1.82 dB)、PSD值(7.35±0.87 dB)均高于中度组\〖(-7.62±1.31 dB)、(4.89±0.62 dB)\〗及轻度组\〖(-4.38±1.05 dB)、(2.57±0.45 dB)\〗(均P<0.05)； 重度组P100波潜伏期(132.41±8.57 ms)长于中度组(118.75±7.32 ms)及轻度组(105.62±6.14 ms)，振幅(7.65±1.53 μV)低于中度组(11.24±1.89 μV)及轻度组(15.38±2.11 μV)(均P<0.05)。Spearman相关性分析显示，OSAHS程度与MD值呈负相关(r_s=-0.901，P<0.05)，与PSD值、P100波潜伏期呈正相关(r_s=0.947、0.807，P<0.05)，与P100波振幅呈负相关(r_s=-0.878，P<0.05)。

结论：OSAHS程度与AION患者RNFL厚度、视野缺损程度及VEP参数密切相关，OSAHS病情越严重，患者视神经结构与功能损伤越显著； 监测AHI、mSaO₂指标可辅助AION患者病情评估及个体化干预方案制定。

METHODS: A retrospective case-control study. Patients diagnosed with AION complicated by OSAHS at the Department of Ophthalmology, the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, between June 2022 and October 2025 were selected as the study subjects. According to the AHI and mSaO₂, the patients were divided into three groups: a mild group(AHI 5-15 events/h, mSaO₂ 85%-90%), moderate group(AHI 16-30 events/h, mSaO₂ 80%-85%), and severe group(AHI >30 events/h, mSaO₂ <80%). General demographic data, retinal nerve fiber layer(RNFL)thickness, visual field defect indicators including mean defect(MD)and pattern standard deviation(PSD), as well as VEP parameters(P100 latency and amplitude)were compared among the three groups.

RESULTS: This study included a total of 110 patients with AION complicated by OSAHS. Based on the severity of OSAHS, the patients were divided into a mild group of 37 patients(21 men and 16 women, mean age 62.15±9.37 y), a moderate group of 35 patients(20 men, 15 women; mean age 61.82±8.94 y), and a severe group of 38 patients(22 men, 16 women; mean age 63.02±9.61 y). There were no significant differences among the three groups in terms of age, sex, TG, TC, LDL-C, HDL-C levels, or AION severity(all P>0.05); however, there were significant differences in history of hypertension, history of diabetes, systolic blood pressure, diastolic blood pressure, and FPG levels(all P<0.05). The mean RNFL thickness in the severe group(63.27±5.58 μm)was significantly lower than that in the moderate group(74.14±6.28 μm)and the mild group(83.22±7.02 μm), and the moderate group was lower than the mild group(all P<0.05); The MD value(-11.57±1.82 dB)and PSD value(7.35±0.87 dB)in the severe group were both higher than those in the moderate group \〖(-7.62±1.31 dB),(4.89±0.62 dB)\〗 and the mild group \〖(-4.38±1.05 dB),(2.57±0.45 dB)\〗(all P<0.05); the P100 latency in the severe group(132.41±8.57 ms)was longer than that in the moderate group(118.75±7.32 ms)and the mild group(105.62±6.14 ms), and the amplitude(7.65±1.53 μV)was lower than that of the moderate group(11.24±1.89 μV)and the mild group(15.38±2.11 μV)(all P<0.05). Spearman's correlation analysis revealed that the severity of OSAHS was negatively correlated with the MD value(r_s=-0.901, P<0.05)and positively correlated with the PSD value and P100 latency(r_s=0.947, 0.807, P<0.05), and was negatively correlated with P100 amplitude(r_s=-0.878, P<0.05).

CONCLUSION:The severity of OSAHS is closely associated with RNFL thickness, visual field defects, and VEP parameters in patients with AION; the more severe the OSAHS, the more pronounced the structural and functional damage to the optic nerve. Monitoring AHI and mSaO₂ can aid in assessing the condition of patients with AION and developing personalized intervention plans.