Peripheral neuropathy: A neglected cause of disability in COPD - A narrative review

Retinal Nerve Fiber Layer Changes in Patients With Chronic Obstructive Pulmonary Disease Compared to Healthy Controls: A Meta-analysis

BACKGROUND AND OBJECTIVE

This study investigated changes in retinal nerve fiber layers (RNFL) in patients diagnosed with chronic obstructive pulmonary disease (COPD) compared to healthy control patients, using optical coherence tomography.

METHODS

PubMed, Cochrane Library, and Google Scholar databases were systematically searched for published articles comparing RNFL between patients with COPD and healthy controls. Standardized mean difference (SMD) with 95% confidence interval (CI) was computed to compare continuous variables.

RESULTS

Average RNFL thickness was significantly reduced in COPD patients compared to healthy controls (SMD = -0.31, 95% CI = -0.48 to -0.14, P = 0.0004, I2 = 0%). Average RNFL thickness did not differ significantly between patients with mild/moderate COPD and healthy controls (SMD = -0.17, 95% CI = -0.39 to 0.04, P = 0.12, I2 = 2%), while a statistically significant reduction in average RNFL thickness was noticed in patients with severe COPD compared to healthy controls (SMD = -0.72, 95% CI = -1.23 to -0.21, P = 0.006, I2 = 83%). Average RNFL thickness was significantly higher in patients with mild/moderate COPD compared to patients with severe COPD (SMD = 0.69, 95% CI = 0.29 to 1.09, P = 0.0008, I2 = 66%).

CONCLUSIONS

This meta-analysis showed that RNFL thickness was decreased in patients with COPD compared to healthy controls. Patients diagnosed with severe COPD seem to be more affected and have thinner RNFL. [Ophthalmic Surg Lasers Imaging Retina 2024;55:334-342.].

The Burden of Comorbidities in Obstructive Sleep Apnea and the Pathophysiologic Mechanisms and Effects of CPAP

Micro-arousals and the repeated desaturation of oxyhemoglobin, which are typical in obstructive sleep apnea syndrome (OSAS), have adverse effects on the health of patients, leading to a wide range of complications such as cardiovascular (arterial hypertension, pulmonary hypertension, chronic heart failure, arrhythmias, myocardial infarction), cerebrovascular (strokes), metabolic (insulin resistance, obesity, diabetes mellitus, metabolic syndrome), gastrointestinal (non-alcoholic liver disease), urinary (chronic renal failure), and neuropsychiatric complications as well as a wide range of malignancies. These, in turn, have multilateral effects on familial, occupational, and social life, as well as increasing the risks of road traffic accidents and accidents at the workplace. Awareness, timely screening, and the prevention of complications play important roles in diagnosing and treating comorbid conditions. This review focuses on comorbidities in OSAS and the effect of Continuous Positive Airway Pressure (CPAP) therapy on their prognoses.