Investigation of the Presence of Glaucoma in Patients with Obstructive Sleep Apnea Syndrome Using and Not Using Continuous Positive Airway Pressure Treatment

Abstract

Objectives: To evaluate the frequency of glaucoma in patients with obstructive sleep apnea syndrome (OSAS) using and not using continuous positive airway pressure treatment. Materials and Methods: This prospective study included 59 patients diagnosed with OSAS based on the Apnea-Hypopnea Index (AHI). OSAS patients were divided into 3 groups according to their AHI scores: 5-15 was considered mild (19 patients), 16-30 was considered moderate (16 patients), and >30 (24 patients) was considered severe. Twenty-eight (47.5%) of the OSAS patients had been using continuous positive airway pressure treatment. The control group included 19 healthy subjects. Retinal nerve fiber layer and ganglion cell complex (GCC) thickness analyses were performed. Results: Average GCC thickness in left eyes was significantly lower in the mild OSAS group than in the control group (p=0.013). The GCC was significantly thinner in the inferior and inferonasal sectors of both eyes in the mild OSAS group compared to the control group (p=0.029, p=0.022, p=0.037, and p=0.019 respectively). Minimum GCC thickness in the left eyes of all OSAS groups was significantly lower than in the control group (p<0.05). Conclusion: In OSAS patients, there may be changes in retinal nerve fiber layer and ganglion cell complex thickness before alterations in the visual field emerge.

A Narrative Review of the Association between Obstructive Sleep Apnea and Glaucoma in Adults

“…Abdullayev et al [ 29 ] conducted a prospective study including 59 patients with OSA ( n = 28 with CPAP) and 19 controls to evaluate the prevalence of glaucoma in OSA patients using and not using CPAP compared to controls. Based on the AHI, all patients with OSA were divided into three groups: 19 patients with mild OSA (32.2 %), 16 patients with moderate OSA (27.1 %) and 24 patients with severe OSA (40.67 %).…”

“…Abdullayev et al [ 29 ] compared ophthalmological parameters of CPAP users, OSA patients without CPAP and controls. There were no statistically significant differences in IOP, CCT and cup/disk ratio in the three groups.…”

“…Overall, a total of 19 studies with 316,178 participants were included in this review [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. The diagnosis of OSA was based on the AHI measured using polysomnography or home sleep-apnea testing.…”

Ocular Complications of Obstructive Sleep Apnea

“…Anatomically, a thinner retinal nerve fiber layer (RNFL) [ 38 , 39 , 40 ], lower ganglion cell complex thickness [ 41 , 42 ], lower peripapillary vessel density, and increased foveal avascular zone in optical coherence tomography angiography [ 43 , 44 ] are all reported in patients with greater OSA severity. Functionally, a higher incidence of visual field defects, which correlate with AHI in NTG [ 45 ], as well as an amplitude reduction and longer latency period in visual evoked potential (VEP), has been reported [ 46 , 47 ].…”

“… Kara, 2018 [ 41 ] Turkey 195 There was a significant negative correlation between the severity of OSA and the thickness of the ganglion cell layer. Abdullayev, 2019 [ 42 ] Turkey 59 The ganglion cell complex was significantly thinner in OSA patients than in the controls. Ucak, 2020 [ 44 ] Turkey 104 Severe OSA was significantly associated with higher IOP values ( p = 0.001) and lower average RNFL thickness ( p = 0.001).…”