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Reply

Reply to La Marca et al. Comment on “Naranjo-Bonilla et al. Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months. Int. J. Environ. Res. Public Health 2022, 19, 12637”

by
Pedro Naranjo-Bonilla
1,2,*,
Rafael Giménez-Gómez
3,
María Carmen Muñoz-Villanueva
4 and
Bernabé Jurado-Gámez
5
1
Ophthalmology Department, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
2
Ophthalmology Department, University Hospital Juan Ramón Jiménez, 21005 Huelva, Spain
3
Ophthalmology Department, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), University Hospital Reina Sofía, 14004 Córdoba, Spain
4
Primary Care Health Centre, Córdoba-Guadalquivir Health District, 14011 Córdoba, Spain
5
Respiratory Department, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University Hospital Reina Sofía, University of Córdoba, 14004 Córdoba, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2023, 20(2), 1141; https://doi.org/10.3390/ijerph20021141
Submission received: 30 December 2022 / Accepted: 4 January 2023 / Published: 9 January 2023
Versions Notes
Thank you for your interest [1] in our work [2].
In all choroidal thickness (ChT) images, the drawn lines are at the level of the RPE. In a recent study, we analyzed our intraobserver reproducibility for measurements of the choroid, and the intraclass correlation coefficients for measurements at the foveal, temporal, and nasal levels were 0.94, 0.87, and 0.80, respectively [3].
All follow-up images were captured using the follow-up setting.
Both the axial length and refractive defect were recorded. These data were not published because the scope of the journal was not strictly ophthalmological. The mean of axial length was 23.50 ± 0.91 mm. In any case, we were not comparing different subjects for which it would be useful to check for axial length differences between them. What we compared were data obtained in different follow-up visits, so we can assume that a given subject will have a similar axial length in each visit and that this measurement will have no effect on the results.
Our group recently conducted a study in which we compared patients with severe obstructive sleep apnea (OSA) who did or did not undergo continuous positive airway pressure (CPAP) treatment to determine which effects are secondary to OSA and which are the consequence of CPAP [3].
In this study we observe patients in the group OSA + CPAP have a higher index apnea hypopnea (IAH) pre-CPAP than patients OSA no-CPAP (61.8 vs. 37.2 events/hour p < 0.001). We observe patients in the group OSA + CPAP have a higher foveal and temporal ChT pre-CPAP than OSA no-CPAP (271.29 vs. 232.16 µm, p = 0.018; 263.00 vs. 227.37 µm, p = 0.010). The more severe the IAH, the higher the ChT. After 3 months of follow-up, we do not observe changes in the OSA no-CPAP group. After 3 months of follow-up, we observed a reduction in temporal ChT in OSA + CPAP group (263.00 vs. 248.52 µm, p = 0.003). In conclusion, CPAP therapy could normalize ChT in severe OSA patients.
We refer to this article as the present study, as it is a continuation of the one designed to examine the effects of 12 months of CPAP therapy.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of Universitiy Hospital Reina Sofia, Ethics Committee, Acta nº219, Ref:2240. Date of approval 30/05/2013.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available on request from the corresponding author.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. La Marca, A.; Biondino, D.; Gioia, M. Comment on Naranjo-Bonilla et al. Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months. Int. J. Environ. Res. Public Health 2022, 19, 12637. Int. J. Environ. Res. Public Health 2023, 20, 1139. [Google Scholar] [CrossRef]
  2. Naranjo-Bonilla, P.; Giménez-Gómez, R.; Muñoz-Villanueva, M.C.; Jurado-Gámez, B. Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months. Int. J. Environ. Res. Public Health 2022, 19, 12637. [Google Scholar] [CrossRef] [PubMed]
  3. Naranjo-Bonilla, P.; Muñoz-Villanueva, M.C.; Giménez-Gómez, R.; Jurado-Gámez, B. Retinal and choroidal thickness measurements in obstructive sleep apnea: Impacts of continuous positive airway pressure treatment. Graefe’s Arch. Clin. Exp. Ophthalmol. 2021, 259, 3381–3393. [Google Scholar] [CrossRef] [PubMed]
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MDPI and ACS Style

Naranjo-Bonilla, P.; Giménez-Gómez, R.; Muñoz-Villanueva, M.C.; Jurado-Gámez, B. Reply to La Marca et al. Comment on “Naranjo-Bonilla et al. Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months. Int. J. Environ. Res. Public Health 2022, 19, 12637”. Int. J. Environ. Res. Public Health 2023, 20, 1141. https://doi.org/10.3390/ijerph20021141

AMA Style

Naranjo-Bonilla P, Giménez-Gómez R, Muñoz-Villanueva MC, Jurado-Gámez B. Reply to La Marca et al. Comment on “Naranjo-Bonilla et al. Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months. Int. J. Environ. Res. Public Health 2022, 19, 12637”. International Journal of Environmental Research and Public Health. 2023; 20(2):1141. https://doi.org/10.3390/ijerph20021141

Chicago/Turabian Style

Naranjo-Bonilla, Pedro, Rafael Giménez-Gómez, María Carmen Muñoz-Villanueva, and Bernabé Jurado-Gámez. 2023. "Reply to La Marca et al. Comment on “Naranjo-Bonilla et al. Retinal and Choroidal Effects of Continuous Positive Airway Pressure as Treatment for Sleep Apnea: Results at 12 Months. Int. J. Environ. Res. Public Health 2022, 19, 12637”" International Journal of Environmental Research and Public Health 20, no. 2: 1141. https://doi.org/10.3390/ijerph20021141

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