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dc.contributor.advisorToquica Osorio, Jeanneth Eloyne
dc.contributor.authorCerquera Jaramillo, Maria Alejandra
dc.contributor.otherLópez Orozco, Diana Marcela
dc.contributor.otherMoreno Mazo, Sara Edith
dc.coverage.spatialHospital Militar Centralspa
dc.coverage.temporal2013-2018spa
dc.date.accessioned2021-01-18T17:00:31Z
dc.date.available2021-01-18T17:00:31Z
dc.date.issued2020-11-12
dc.identifier.urihttp://hdl.handle.net/10654/37387
dc.description.abstractSe trata de un estudio observacional, descriptivo de tipo corte transversal mediante el cual se determino la prevalencia, alteraciones funcionales y estructurales del glaucoma primario de ángulo abierto (GPAA) en pacientes con apnea obstructiva del sueño (AOS). Se escogieron pacientes con diagnostico por polisomnograma de AOS entre 2013 y 2018, para determinar el índice de apena/hipoapnea (IAH) y los antecedentes clínicos, a los cuales se les realizó un examen oftalmológico que incluyo: agudeza visual (AV), biomicroscopia, presión intraocular (PIO), gonioscopía indirecta y oftalmoscopia. Los pacientes con sospecha de glaucoma se les efectuó campo visual y Tomografía Óptica de coherencia (OCT) de nervio óptico. Se estudiaron 150 pacientes con diagnóstico de AOS, para un total 300 ojos examinados, de los cuales 42,7% fueron mujeres y 57.3% hombres, con edad media 66.8 (± 12.1). En los antecedentes, 1.3% tenían antecedente familiar de glaucoma, 64.7% hipertensión arterial y 20.7% diabetes mellitus. El índice AIH se categorizo como leve en 62%, moderado en 17.3% y severo en 20.7%. La prevalencia de GPAA fue de 1.3% (IC:0.69-1.3%), mientras que para sospecha de glaucoma fue de 0.95% (IC:8.9-16.4%). La AV estuvo en el rango de 20/20 a 20/60 en el 94.6% de los casos, con una prevalencia de ceguera legal de 0.03% (IC:0.00 -0.14). La PIO media obtenida fue de 13 (± 2.6). En la valoración del nervio óptico, no se observaron alteraciones en 74.6% de casos, mientras las alteraciones mas frecuentes fueron adelgazamiento focal o difuso del reborde neural (16.6%) en el grupo de severidad leve, seguido por la asimetría del disco mayor a 0.2 mm (8.6%), en el grupo de severidad severa. En el campo visual, 54.4% no evidenciaron alteraciones y en el 41% restante presentaron defectos focales tipo arqueado, escalón nasal y paracentrales en el grupo de severidad leve. En los resultados del OCT, los valores fueron en mayor proporción normales, mientras, que los resultados anormales fue incrementando el daño estructural del nervio al pasar de AOS leve y moderado a severo. En conclusión, el estudio demostró relación entre los cambios estructurales del nervio óptico y la severidad de la AOS. Esto sugiriendo que la AOS puede influir en la anatomía del nervio óptico, favoreciendo al desarrollo de una neuropatía óptica y en cierto modo a la aparición de GPAA. Las alteraciones funcionales anormales en el campo visual indicaron que estadios leves del AOS pueden estar relacionados con mayores compromisos del campo visual. Asociado, las alteraciones estructurales anormales en la OCT fueron incrementando al pasar de AOS leve y moderado a severo, infiriendo asociación para el desarrollo de GPAA en paciente con AOS. Se recomienda la realización de futuros estudios clínicos para identificar la necesidad de realizar estudios y seguimientos a los pacientes con AOS para descartar glaucoma como una de sus múltiples manifestaciones sistémicas.spa
dc.description.tableofcontentsRESUMEN.................................................................................................................3 IDENTIFICACIÓN Y FORMULACIÓN DEL PROBLEMA................................................... 6 OBJETIVOS E HIPÓTESIS..........................................................................................10 a. General .............................................................................................10 b. Específicos.........................................................................................10 c. Hipótesis............................................................................................10 METODOLOGÍA........................................................................................................11 a. Tipo y diseño general del estudio ...........................................................11 b. Lugar....................................................................................................11 c. Población ............................................................................................11 d. Variables y Mediciones...........................................................................11 e. Muestra................................................................................................14 a. Selección de la muestra.................................................................... 14 b. Calculo del tamaño de la muestra ......................................................14 c. Criterios de selección de inclusión y exclusión ..................................14 d. Mediciones e instrumentos utilizados.................................................14 e . Plan de recolección de datos...............................................................15 PLAN DE ANÁLISIS................................................................................................. 18 a. Métodos y modelos de análisis de los datos según tipo de variables b. Programas a utilizar para análisis de datos. c. Control de sesgos ASPECTOS ÉTICOS ................................................................................................18 RESULTADOS .........................................................................................................19 DISCUSIÓN ............................................................................................................ 23 CONCLUSIONES...................................................................................................... 26 REFERENCIAS BIBLIOGRÁFICAS ............................................................................. 26spa
dc.format.mimetypeapplicaction/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subject.meshOFTALMOLOGIAspa
dc.subject.meshGLAUCOMAspa
dc.subject.meshAPNEA OBSTRUCTIVA DEL SUEÑOspa
dc.subject.meshPRESION DE LAS VIAS AEREAS POSITIVA CONTINUAspa
dc.titleCaracterización de la prevalencia, alteraciones estructurales y funcionales del glaucoma primario de ángulo abierto en pacientes con apnea obstructiva del sueño en población colombiana en el Hospital Militar Central desde 2013 hasta 2018spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2*
dc.type.localTesis/Trabajo de grado - Monografía - Especializaciónspa
dc.description.abstractenglishThis is an observational, descriptive, cross-sectional study that determines the prevalence, functional and structural alterations of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnea (OSA). Patients between 2013 and 2018 with diagnosis of OSA by polysomnogram were chosen to determine the apnea/hypopnea index (AHI) and antecedents. Patients underwent an ophthalmological examination that included: visual acuity (VA), biomicroscopy, intraocular pressure (IOP), indirect gonioscopy and ophthalmoscopy. Patients with diagnosis of glaucoma suspect underwent a visual field and Optical Coherence Tomography (OCT) of the optic nerve. It was studied 150 patients with a diagnosis of OSA, for a total of 300 eyes examined, of which 42.7% were women and 57.3% men, with a mean age of 66.8 (± 12.1). In the antecedents, 1.3% had a family history of glaucoma, 64.7% hypertension, and 20.7% diabetes mellitus. The AIH index was categorized as mild in 62%, moderate in 17.3% and severe in 20.7%. The prevalence of POAG was 1.3% (CI:0.69-1.3%), while for glaucoma suspect was 0.95% (CI:8.9-16.4%). VA was in the range of 20/20 to 20/60 in 94.6% of the cases, with a prevalence con legal blindness od 0.0% (CI: 0.00-0.14). The mean IOP obtained was 13 (± 2.6). In the evaluation of the optic nerve, no alterations were observed in 74.6% of cases, while the most frequent alterations were focal or diffuse thinning of the neural rim (16.6%), in the mild severity group, followed by disc asymmetry greater than 0.2 mm (8.6%), in the severe severity group. In the visual field, 54.4% did not show alterations and in the remaining 41% presented arcuate, nasal step and paracentral focal defects in the mild severity group. In the OCT results, the values were normal in a higher proportion without significant differences. In patients with abnormal results, the structural damage of the nerve increased from mild and moderate OSA to severe. In conclusion, the study demonstrated a relationship between the structural changes of the optic nerve and the severity of OSA. This suggests that OSA can influence the anatomy of the optic nerve, favoring the development of optic neuropathy and, to a certain extent, the appearance of POAG. The abnormal functional alterations in the visual field indicated that mild stages of OSA may be related to greater visual field compromises. Associated, abnormal structural alterations in OCT increased from mild and moderate OSA to severe, inferring an association for the development of POAG in a patient with OSA. Future clinical studies are recommended to identify the need for studies and follow-ups of patients with OSA to rule out glaucoma as one of its multiple systemic manifestations.spa
dc.title.translatedCharacterization of the prevalence, structural and functional alterations of Primary Open Angle Glaucoma in patients with obstructive sleep apnea in a Colombian population at the Central Military Hospital from 2013 to 2018spa
dc.subject.keywordsGlaucoma suspectspa
dc.subject.keywordsPrimary Open-Angle glaucomaspa
dc.subject.keywordsOptic Coherence Tomographyspa
dc.subject.keywordsVisual Fieldspa
dc.subject.keywordsObstructive sleep apneaspa
dc.publisher.programOftalmologíaspa
dc.creator.degreenameEspecialista en Oftalmologíaspa
dc.subject.decsOFTALMOLOGIAspa
dc.subject.decsTrastornos del sueño - Diagnósticospa
dc.subject.decsApnea del Sueñospa
dc.subject.decsGlaucomaspa
dc.subject.decsNervio óptico - Enfermedadesspa
dc.description.degreelevelEspecializaciónspa
dc.publisher.facultyFacultad de Medicinaspa
dc.type.driverinfo:eu-repo/semantics/bachelorThesisspa
dc.rights.creativecommonsAttribution-NonCommercial-NoDerivatives 4.0 Internationalspa
dc.relation.references1. Bagabas, N, Ghazali, W, Mukhtar, M, AlQassas, I, Merdad, R, Maniyar, A, Almarzouki, N, Afreen, H, Badeed, O, Wali, S. Prevalence of Glaucoma in Patients with Obstructive Sleep Apnea. Journal of Epidemiology and Global Health. Vol 9 (3). Sept. 2019. Pp198-203spa
dc.relation.references2. Friedlander, A, Graves, L, Chang, T, Kawakami, K, Lee, U, Grabich, S, Fang, Z, Zeidler, M, Giaconi, J. Prevalence of primary open-angle glaucoma among patients with obstructive sleep apnea. Oral and Maxillofacial Surgery. Elseiver. 2018spa
dc.relation.references3. Wozniak, D, Bourne, R, Peretz, G, Kean, J, Willshire, C, Harun, S, Villar, S, Chiu, Y, Smith, I. Obstructive Sleep Apnea in Patients with primary open-angle glaucoma: No Role for a Screening Program.Journal Glaucoma. Vol 28 (8). 2019spa
dc.relation.references4. Carnero E, Bragard J, Urrestarazu E, Rivas E, Polo V, Larrosa JM, et al. (2020) Continuous intraocular pressure monitoring in patients with obstructive sleep apnea syndrome using a contact lens sensor. PLoS ONE 15(3): e0229856spa
dc.relation.references5. Tsang CS, Chong SL, Ho CK, Li MF. Moderate to severe obstructive sleep apnea patients is associated with a higher incidence of visual field defect. Eye. 2006; 20:38–42spa
dc.relation.references6. Sergi M, Salerno DE, Rizzi M, Blini M, Andreoli A, Messenio D, et al. Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma. 2007; 16: 42–46.spa
dc.relation.references7. Swaminatha, S, Bhakta, A, Shi, Wei, Feuer, W, Abreu, A, Chediak, A, Greenfield, D. Is Obstructive Sleep Apena Associated with Progressive Glaucomatous Optic Neuropathy? J Glaucoma 2018; 27:1-6.spa
dc.relation.references8. Salzgeber, R. Iliev, M. Mathis, J. Do Optic Nerve Head and visual Field parameters in patients with obstructive sleep apnea syndrome differ from those in control individuals? Klin Monatsbl Augenheilkd 2014; 231: 340–343spa
dc.relation.references9. Zhao, X, Yang, C, Zhang, J, Zheng, Hui, Liu, P, Li, Q. Obstructive Sleep Apnea and Retinal Nerve Fiber Layer Thickness: A Meta-analysis. J Glaucoma 2016; 25:e414-e418.spa
dc.relation.references10. Yu JG, Mei ZM, Ye T, et al. Changes in retinal nerve fiber layer thickness in obstructive sleep apnea/hypopnea syndrome: a meta- analysis. Ophthalmic Res. 2016; 56:57–67.spa
dc.relation.references11. Sun CL, Zhou LX, Dang Y, Huo YP, Shi L, Chang YJ. Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea syndrome: a meta-analysis. Medicine. 2016; 95:e4499.spa
dc.relation.references12. Wang JS, Xie HT, Jia Y, Zhang MC. Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome: a sys- tematic review and Meta-analysis. Int J Ophthalmol. 2016; 9: 1651–6.spa
dc.relation.references13. Wang W, He M, Huang W. Changes of retinal nerve fiber layer thickness in obstructive sleep apnea syndrome: a systematic review and meta-analysis. Curr Eye Res. 2017; 42:796–802.spa
dc.relation.references14. Cioffi,G. Durcan, F. Girkin, C. Gupta, N. Piltz-Seymour,J. Samuelson, T. Tanna, A. Barton, K. O’Connell, S. Basic and Clinical Science Course: Glaucoma. Foundation of the American Academy of Ophthalmology; 2016-2017 pp.21-25spa
dc.relation.references15. Allingham, R. Damji, K. Freedman, S. Moroi, S. Rhee, D. Shields Textbook of Glaucoma. 6th ed. Lippincot Williams & Wilkins; 2011. pp.130-135spa
dc.relation.references16. Guías de Práctica Clínica sobre Glaucoma de Ángulo Abierto (2017). Guías de Práctica Clínica en el SNS, Ministerio de Sanidad, Servicios Sociales e Igualdad, p.1-10 Disponible: http://www.guiasalud.es/GPC/GPC_568_Glaucoma_AQUAS_compl.pdfspa
dc.relation.references17. European Glaucoma Society (2014). Terminología y Pautas para el Glaucoma. 4th ed. Sociedad Europea de Glaucoma, p79-81. Disponible www.eugs.orgspa
dc.relation.references18. Skorin, J.Knutson, R. Ophthalmic Diseases in Patients with Obstructive Sleep Apnea. The Journeal of the American Osteopathic Association. 2016:16:8:522-529spa
dc.relation.references19. Shulin, L. Lin, Y. Xin, L. Meta-Analysis of Association of Obstructive Sleep Apnea with Glaucoma. Journal of Glaucoma. Clinical & Experimental Ophthalmology 2016:25:1-7spa
dc.relation.references20. Faridi, O, Chul Park, S, Liebmann, J, Ritch, R. Glaucoma and Obstructive sleep apnoea syndrome. 2010; 40:408-419.spa
dc.relation.references21. Houn, L, Yunh-Chaun Liu, S. Camacho, M. Guilleminault, C. The association between ophthalmologic diseases and obstructive sleep apnea: A systematic review and meta-analysis. Sleep Breath, Springer. 2016:20:1145-1154spa
dc.relation.references22. West, S. Turnbull, C. Eye disorders associated with obstructive sleep apnea. Wolters Kluer Health,Inc. 2016:22:6:595-600spa
dc.relation.references23. Yee Fang, S. Wan Abdul Halim, W. Mat Baki, M. Effect of prolonged supine position on the intraocular pressure in patients with obstructive sleep apnea syndrome. Graef´s Archive for Clinical and Experimental Ophthalmology. 2018:256:783-790spa
dc.relation.references24. Mentek, M, Aptel, F, Godin-Ribuot, D, Tamisier, R, Pepin, J, Chiquet, C. Diseases of the Retina and the Optic Nerve associated with obstructive sleep apnea.' Elseiver (2018) 113-130spa
dc.relation.references25. Ohana, B, Blumen, M.B, Bluwol, E, Derri, M, Chabolle, F, Nordmann J.P. Primary Open Angle Glaucoma a Snoring: Prevalence of OSAS. Elseiver. (2010)127, 159-164.spa
dc.relation.references26. Sagvi, O, Fishelson-Arev, T, Buckman, G, Mathalone, N, Wolson, J, Segev, E, Peled, R, Lavi, I, Geyer, O. Retinal nerve fiber layer thickness measurements by optical coherence tomography in patients with sleep apnoea syndrome. Clinical & Experimental Ophthalmology 2014; 42: 132-138spa
dc.relation.references27. Wang, J, Xie, H, Jia, Y, Zhang, M. Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome: a systematic review and Meta- analysis. Int J Ophthalmol, 2016; 9, 11.1651-1656.spa
dc.relation.references28. Santos, M, Hofmann. J, Ocular Manifestations of Obstructive Sleep Apena. Journal of Clinical Sleep Medicine, Vol. 13, No. 11, 2017.spa
dc.relation.references29. Chen, X. Zhang, W. Wang, L. Yang, D. Wang, J. Changes of visual field and optic nerve fiber layer in patients with OSAS. Sleep Breath (2015) 19:129–134spa
dc.relation.references30. Xinhua Wu, Huanbo Liu, Obstructive sleep apnea/hypopnea syndrome increases glaucoma risk: evidence from a meta-analysis. Int J Clin Exp Med 2015;8(1):297-303spa
dc.relation.references31. Shi Y, Liu P, Guan J, Lu Y, Su K. Association between glaucoma and obstructive sleep apnea syndrome: a meta-analysis and systematic review. PLoS ONE. 2015; 10:e0115625spa
dc.relation.references32. Moghimi S, Ahmadraji A, Sotoodeh H, Sadeghniat K, Maghsoudipour M, Fakhraie G, et al. Retinal nerve fiber thickness is reduced in sleep apnea syndrome. Sleep Med. 2013; 14: 53–57spa
dc.relation.references33. Nowak MS, Jurowski P, Gos R, Prost ME, Smigielski J. Pulsatile ocular blood flow in subjects with sleep apnoea syndrome. Arch Med Sci. 2011; 2: 332–336.spa
dc.relation.references34. Shalaby, A. Eshazly,M.Sayed, Y.Selin,S, Abdelhamid, H. Co-existence of obstructive sleep apnea and primary open angle glaucoma Egyptian Journal of Chest Diseases and Tuberculosis (2016) 65, 511–516spa
dc.relation.references35. Uslu, H. Kanra, A. Sarac, S. Structural Assement of the optic nerve in patients with obstructive sleep apena syndrome: case-control study. European Journal of Ophthalmology.2020.0(0) 1-8spa
dc.relation.references36. Lin PW, Friedman M, Lin HC, et al. Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome. Graefes Arch Clin Exp Ophthalmol 2011; 249: 585–593.spa
dc.relation.references37. Stamper, R. Lieberman, M.Drake, M. Becker – Shaffer’s. Diagnosis and Therapy of the Glaucoma. 8th ed. Mosby Elseiver; 2009. P.109-187spa
dc.relation.references38. Fan, Y. Su, W. Liu, C. Chen, H. Wu, S. Chang, S. Chen, K. Wu, W. Chen, N, Li, H. Sun, M. Correlation between structural progression in glaucoma and obstructive sleep apena. Eye. (2019) 33:1459-146spa
dc.relation.references39. Kara N, Sayin N, Bayramoglu SE, et al. Peripapillary retina nerve fiber layer thickness and macular ganglion cell layer thickness in patients with obstructive sleep apnea syndrome. Eye 2018; 32(4): 701–706.spa
dc.relation.references40. Abdullaey, A. Tekeli, O. Yanik, O. Acican, T.Gulbay. Investigation of the Presence of Glaucoma in Patients with Obstructive Sleep Apnea Syndrome Using and Not Using Continuous Positive Airway Pressure Treatment. Turk J Ophthalmol 2019;49:134-141spa
dc.subject.proposalSospecha de Glaucomaspa
dc.subject.proposalGlaucoma primario de ángulo abiertospa
dc.subject.proposalApena obstructiva del sueñospa
dc.subject.proposalCampo visualspa
dc.subject.proposalTomografía óptica de coherenciaspa
dc.publisher.grantorUniversidad Militar Nueva Granadaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_7a1f*
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.identifier.instnameinstname:Universidad Militar Nueva Granadaspa
dc.identifier.reponamereponame:Repositorio Institucional Universidad Militar Nueva Granadaspa
dc.identifier.repourlrepourl:https://repository.unimilitar.edu.cospa
dc.rights.localAcceso abiertospa
dc.coverage.sedeMedicinaspa


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