{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T01:06:32Z","timestamp":1776128792901,"version":"3.50.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T00:00:00Z","timestamp":1750464000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T00:00:00Z","timestamp":1750464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003010","name":"Ege University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003010","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Jpn J Ophthalmol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Evaluation of scleral thickness with anterior segment optical coherence tomography (AS-OCT) in patients with obstructive sleep apnea syndrome (OSAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 30 severe (Group 1), 30 moderate (Group 2) and 30 mild (Group 3) OSAS patients and 22 healthy volunteers (Group 4) were included in the study. Scleral thickness measurements were taken with AS-OCT, 6 mm, 4 mm and 2 mm posterior to the scleral spur, in four gaze positions. Data and findings were examined comparatively\n                      <jats:bold>.<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 6 mm posterior to the scleral spur, the mean thickness was found to be significantly higher in all quadrants in Group 1 (p&lt;0.05 for all). Superior thickness was higher in Group 2 compared to Group 4 (p=0.034). At 4 mm posterior to the scleral spur; in Group 1, the mean thickness was found higher than Group 2 and 3 only in the inferior (p=0.01, p=0.021, respectively) and was found higher than Group 4 in the nasal and inferior (p&lt;0.001, p=0.006, respectively). At 2 mm posterior to the scleral spur; significant difference was observed between Groups 1 and 2 only in the inferior (p=0.002), between Groups 1 and 3 in the nasal and inferior (p=0.029, p=0.002), and between Groups 1 and 4 the in nasal and inferior (p=0.002, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The scleral thickness measured from 6 mm posterior to the scleral spur was higher in all quadrants in patients with severe OSAS. It is possible that the increase in scleral thickness, especially in severe OSAS, is due to extracellular matrix accumulation in the scleral tissue.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10384-025-01234-y","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T23:03:05Z","timestamp":1750460585000},"page":"870-875","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Scleral thickness in patients with obstructive sleep apnea syndrome"],"prefix":"10.1007","volume":"69","author":[{"given":"Zeynep","family":"Akgun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cumali","family":"Degirmenci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sezai","family":"Tasbakan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozen K","family":"Basoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melis","family":"Palamar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,21]]},"reference":[{"key":"1234_CR1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1038\/nrcardio.2010.145","volume":"7","author":"M Kohler","year":"2010","unstructured":"Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol. 2010;7:677\u201385.","journal-title":"Nat Rev Cardiol"},{"key":"1234_CR2","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1093\/aje\/kws342","volume":"177","author":"PE Peppard","year":"2013","unstructured":"Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006\u201314.","journal-title":"Am J Epidemiol"},{"issue":"9 Suppl 1","key":"1234_CR3","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3949\/ccjm.86.s1.02","volume":"86","author":"JV Rundo","year":"2019","unstructured":"Rundo JV. Obstructive sleep apnea basics. Cleve Clin J Med. 2019;86(9 Suppl 1):2\u20139.","journal-title":"Cleve Clin J Med"},{"key":"1234_CR4","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.5664\/jcsm.9312","volume":"17","author":"LF Nakayama","year":"2021","unstructured":"Nakayama LF, Tempaku PF, Bergamo VC, Polizelli MU, Santos da Cruz NF, Azeredo Bittencourt LR, et al. Obstructive sleep apnea and the retina: a review. J Clin Sleep Med. 2021;17:1947.","journal-title":"J Clin Sleep Med"},{"key":"1234_CR5","doi-asserted-by":"crossref","first-page":"265","DOI":"10.5664\/jcsm.9552","volume":"18","author":"A Garc\u0131a-Sanchez","year":"2022","unstructured":"Garc\u0131a-Sanchez A, Villala\u0131n I, Asencio M, Garc\u0131a J, Garc\u0131a-Rio F. Sleep apnea and eye diseases: evidence of association and potential pathogenic mechanisms. J Clin Sleep Med. 2022;18:265\u201378.","journal-title":"J Clin Sleep Med"},{"key":"1234_CR6","doi-asserted-by":"crossref","first-page":"3422","DOI":"10.3390\/jcm10153422","volume":"10","author":"PK Liu","year":"2021","unstructured":"Liu PK, Chiu TY, Wang NK, Levi SR, Tsai MJ. Ocular complications of obstructive sleep apnea. J Clin Med. 2021;10:3422.","journal-title":"J Clin Med"},{"key":"1234_CR7","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.5664\/jcsm.6812","volume":"13","author":"M Santos","year":"2017","unstructured":"Santos M, Hofmann RJ. Ocular manifestations of obstructive sleep apnea. J Clin Sleep Med. 2017;13:1345.","journal-title":"J Clin Sleep Med"},{"key":"1234_CR8","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/08164622.2021.1924629","volume":"105","author":"JI Fern\u00e1ndez-Vigo","year":"2022","unstructured":"Fern\u00e1ndez-Vigo JI, Shi H, Burgos-Blasco B, Fernandez-Aragon S, De-Pablo-G\u00f3mez-de-Lia\u00f1o L, Kudsieh B, et al. Anterior scleral thickness dimensions by swept-source optical coherence tomography. Clin Exp Optom. 2022;105:13\u20139.","journal-title":"Clin Exp Optom"},{"key":"1234_CR9","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1167\/iovs.03-0796","volume":"45","author":"J Gottanka","year":"2004","unstructured":"Gottanka J, Chan D, Eichhorn M, L\u00fctjen-Drecoll E, Ethier CR. Effects of TGF-beta2 in perfused human eyes. Invest Ophthalmol Vis Sci. 2004;45:153\u20138.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"1234_CR10","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.oret.2020.07.011","volume":"5","author":"N Imanaga","year":"2021","unstructured":"Imanaga N, Terao N, Nakamine S, Wakugawa S, Tamashiro T, Yamauchi Y, et al. Scleral thickness in central serous chorioretinopathy. Ophthalmol Retina. 2021;5:285\u201391.","journal-title":"Ophthalmol Retina."},{"issue":"7","key":"1234_CR11","doi-asserted-by":"crossref","first-page":"E0132902","DOI":"10.1371\/journal.pone.0132902","volume":"10","author":"HD Buckhurst","year":"2015","unstructured":"Buckhurst HD, Gilmartin B, Cubbidge RP, Logan NS. Measurement of scleral thickness in humans using anterior segment optical coherent tomography. PLoS ONE. 2015;10(7):E0132902.","journal-title":"PLoS ONE"},{"key":"1234_CR12","volume":"15","author":"Y Wang","year":"2022","unstructured":"Wang Y, Cao H. Corneal and scleral biomechanics in ophthalmic diseases: an updated review. Med Nov Technol Devices. 2022;15: 100140.","journal-title":"Med Nov Technol Devices."},{"key":"1234_CR13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2174\/1874306401913010019","volume":"13","author":"NE Morsy","year":"2019","unstructured":"Morsy NE, Amani BE, Magda AA, Nabil AJ, Pandi-Perumal SR, Bahammam AS, et al. Prevalence and predictors of ocular complications in obstructive sleep apnea patients: a cross-sectional case-control study. Open Respir Med J. 2019;13:19\u201330.","journal-title":"Open Respir Med J"},{"key":"1234_CR14","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.smrv.2017.05.003","volume":"38","author":"M Mentek","year":"2018","unstructured":"Mentek M, Aptel F, Godin-Ribuot D, Tamisier R, Pepin JL, Chiquet C. Diseases of the retina and the optic nerve associated with obstructive sleep apnea. Sleep Med Rev. 2018;38:113\u201330.","journal-title":"Sleep Med Rev"},{"key":"1234_CR15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/jcm10020277","volume":"10","author":"A Maniaci","year":"2021","unstructured":"Maniaci A, Iannella G, Cocuzza S, Vicini C, Magliulo G, Ferlito S, et al. Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients. J Clin Med. 2021;10:1\u201319.","journal-title":"J Clin Med"},{"key":"1234_CR16","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1001\/archopht.123.4.458","volume":"123","author":"SC Sacc\u00e0","year":"2005","unstructured":"Sacc\u00e0 SC, Pascotto A, Camicione P, Capris P, Izzotti A. Oxidative DNA damage in the human trabecular meshwork: clinical correlation in patients with primary open-angle glaucoma. Arch Ophthalmol. 2005;123:458\u201363.","journal-title":"Arch Ophthalmol"},{"key":"1234_CR17","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/IJG.0b013e3181dde051","volume":"20","author":"C Yoo","year":"2011","unstructured":"Yoo C, Eom YS, Suh YW, Kim YY. Central corneal thickness and anterior scleral thickness in Korean patients with open-angle glaucoma: an anterior segment optical coherence tomography study. J Glaucoma. 2011;20:95\u20139.","journal-title":"J Glaucoma"},{"key":"1234_CR18","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1007\/s00417-021-05523-3","volume":"260","author":"X Yan","year":"2022","unstructured":"Yan X, Li M, Chen Z, Zhou X. The anterior scleral thickness in eyes with primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol. 2022;260:1601.","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"1234_CR19","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1097\/IJG.0000000000002438","volume":"33","author":"O Alpogan","year":"2024","unstructured":"Alpogan O, Un Y, Tekcan H, Kose AO, Bolac R. Evaluation of anterior scleral thickness and angle parameters in eyes with pseudoexfoliation syndrome and glaucoma. J Glaucoma. 2024;33:785\u201393.","journal-title":"J Glaucoma"},{"key":"1234_CR20","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/ceo.14071","volume":"50","author":"SSY Lee","year":"2022","unstructured":"Lee SSY, Nilagiri VK, Mackey DA. Sleep and eye disease: a review. Clin Exp Ophthalmol. 2022;50:334.","journal-title":"Clin Exp Ophthalmol"},{"key":"1234_CR21","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/OPX.0000000000001467","volume":"97","author":"M Pellegrini","year":"2020","unstructured":"Pellegrini M, Bernabei F, Friehmann A, Giannaccare G. Obstructive sleep apnea and keratoconus: a systematic review and meta-analysis. Optom Vis Sci. 2020;97:9\u201314.","journal-title":"Optom Vis Sci"},{"key":"1234_CR22","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.3390\/life13112223","volume":"13","author":"N Burguera-Gim\u00e9nez","year":"2023","unstructured":"Burguera-Gim\u00e9nez N, D\u00edez-Ajenjo MA, Burguera N, Peris-Mart\u00ednez C. Anterior scleral thickness profile in keratoconus. Life. 2023;13:2223.","journal-title":"Life"},{"key":"1234_CR23","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1007\/s00417-008-0837-0","volume":"246","author":"P Kloos","year":"2008","unstructured":"Kloos P, Laube I, Thoelen A. Obstructive sleep apnea in patients with central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2008;246:1225\u20138.","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"1234_CR24","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1007\/s11325-016-1358-4","volume":"20","author":"LK Huon","year":"2016","unstructured":"Huon LK, Liu SYC, Camacho M, Guilleminault C. The association between ophthalmologic diseases and obstructive sleep apnea: a systematic review and meta-analysis. Sleep Breath. 2016;20:1145\u201354.","journal-title":"Sleep Breath."},{"key":"1234_CR25","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1097\/IAE.0000000000002117","volume":"38","author":"CY Wu","year":"2018","unstructured":"Wu CY, Riangwiwat T, Rattanawong P, Nesmith BLW, Deobhakta A. Association of obstructive sleep apnea with central serous chorioretinopathy and choroidal thickness: a systematic review and meta-analysis. Retina. 2018;38:1642\u201351.","journal-title":"Retina"},{"key":"1234_CR26","doi-asserted-by":"crossref","first-page":"5872","DOI":"10.1038\/s41598-021-85229-y","volume":"11","author":"YJ Lee","year":"2021","unstructured":"Lee YJ, Lee YJ, Lee JY, Lee S. A pilot study of scleral thickness in central serous chorioretinopathy using anterior segment optical coherence tomography. Sci Rep. 2021;11:5872.","journal-title":"Sci Rep"},{"key":"1234_CR27","doi-asserted-by":"crossref","first-page":"3474","DOI":"10.1167\/iovs.05-1246","volume":"47","author":"HK Tewari","year":"2006","unstructured":"Tewari HK, Gadia R, Kumar D, Venkatesh P, Garg SP. Sympathetic-parasympathetic activity and reactivity in central serous chorioretinopathy: a case-control study. Invest Ophthalmol Vis Sci. 2006;47:3474\u20138.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"1234_CR28","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1167\/iovs.63.10.2","volume":"63","author":"X Zhou","year":"2022","unstructured":"Zhou X, Fukuyama H, Okita Y, Kanda H, Yamamoto Y, Araki T, et al. Pupillary responses reveal autonomic regulation impairments in patients with central serous chorioretinopathy. Invest Ophthalmol Vis Sci. 2022;63:2.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"1234_CR29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-019-56847-4","volume":"10","author":"K Takeshima","year":"2020","unstructured":"Takeshima K, Tanaka K, Mori R, Wakatsuki Y, Onoe H, Sakakibara T, et al. Central serous chorioretinopathy and heart rate variability analysis with a smartphone application. Sci Rep. 2020;10:1\u20138.","journal-title":"Sci Rep"},{"key":"1234_CR30","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1186\/s12886-023-03038-5","volume":"23","author":"SM Downes","year":"2023","unstructured":"Downes SM, Mall SP, Al-Khuzaei S, Chadha R, Gibson A, Chong V, et al. Combined central serous chorioretinopathy, hypermetropia, short axial length, chorioretinal folds, enlarged\/thickened ocular coats, with varying association of scleral changes (CHAFES). BMC Ophthalmol. 2023;23:322.","journal-title":"BMC Ophthalmol"},{"key":"1234_CR31","first-page":"6980281","volume":"2016","author":"P Wang","year":"2016","unstructured":"Wang P, Yu DJ, Feng G, Long Z-H, Li H, Zhao T-L. Is floppy eyelid syndrome more prevalent in obstructive sleep apnea syndrome patients? J Ophthalmol. 2016;2016:6980281.","journal-title":"J Ophthalmol"},{"key":"1234_CR32","doi-asserted-by":"crossref","first-page":"356","DOI":"10.4274\/tjo.galenos.2020.35033","volume":"50","author":"I Karaca","year":"2020","unstructured":"Karaca I, Ya\u011fc\u0131 A, Palamar M, Ta\u015fbakan MS, Ba\u015fo\u011flu \u00d6K. Evaluation of periorbital tissues in obstructive sleep apnea syndrome. Turk J Ophthalmol. 2020;50:356.","journal-title":"Turk J Ophthalmol."},{"key":"1234_CR33","doi-asserted-by":"crossref","unstructured":"Miyamoto C, Santo LCE, Roisman L, de Andrade Memoria Moreno P, Cariello AJ, et al. Floppy eyelid syndrome: review. Arq Bras Oftalmol. 2011;74:64\u20136.","DOI":"10.1590\/S0004-27492011000100016"},{"key":"1234_CR34","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.18240\/ijo.2024.10.03","volume":"17","author":"Y Sun","year":"2024","unstructured":"Sun Y, Li ZZ, Yang J, Sha Y-R, Hou X-Y, Fu H, et al. Molecular mechanism of hypoxia and alpha-ketoglutaric acid on collagen expression in scleral fibroblasts. Int J Ophthalmol. 2024;17:1780\u201390.","journal-title":"Int J Ophthalmol"}],"container-title":["Japanese Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10384-025-01234-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10384-025-01234-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10384-025-01234-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T17:05:04Z","timestamp":1762880704000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10384-025-01234-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,21]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["1234"],"URL":"https:\/\/doi.org\/10.1007\/s10384-025-01234-y","relation":{},"ISSN":["0021-5155","1613-2246"],"issn-type":[{"value":"0021-5155","type":"print"},{"value":"1613-2246","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,21]]},"assertion":[{"value":"24 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Z. Akgun, None; C. Degirmenci, None; S. Tasbakan, None; O. K. Basoglu, None; M. Palamar, None.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}