Normal-tension glaucoma and obstructive sleep apnea syndrome: a prospective study

Abstract

BackgroundToday, identified risk factors for normal-tension glaucoma (NTG) include abnormal ocular blood flow, abnormal blood coagulation, systemic hypotension, ischemic vascular disorders, and autoimmune diseases. However, pathogenesis of the condition remains unclear. On the other hand, there are also a few studies suggesting that the obstructive sleep apnea syndrome (OSAS) may compromise optic nerve head perfusion and cause glaucomatous optic neuropathy by creating transient hypoxemia and increasing vascular resistance. In this study, we evaluated the possible association between OSAS and NTG.MethodsWe recruited 24 patients with NTG and 24 age and sex matched controls who were also similar for systemic risk factors such as diabetes mellitus (DM), hypertension (HT) and hypercholesterolemia. All patients and controls underwent over-night polysomnography (PSG) for the diagnosis of OSAS and calculation of Apnea-Hypopnea Index (AHI).ResultsPatients and controls were statistically similar in terms of age, sex, gender, smoking, systemic risk factors, neck circumference and body mass index. The subjects with AHI ≥ 20 were accepted as OSAS. Ten (41.7%) of 24 patients with NTG and 3 (12.5%) of 24 controls had OSAS (p < 0.05).ConclusionsThe prevalence of OSAS was higher in patients with NTG and the difference between patient and control groups was statistically significant (p < 0.05).

Prevalence and risk factors of eye diseases in adult patients with obstructive sleep apnoea: results from the SLE.E.P.Y cohort study

“…This is also supported by a relative risk of 3.34 to have OSA in patients with NTG compared with systemic risk factors-matched subjects. 38 NAION was the least frequently observed ED. Although the underlying pathophysiological mechanisms of NAION have not yet been fully elucidated, it has been hypothesised that there is a circulatory insufficiency within the optic nerve head during a nocturnal non-dipping blood pressure Open Access profile promoted by OSA.…”

Update on the Prevalence, Etiology, Diagnosis, and Monitoring of Normal-Tension Glaucoma

“…68,69 Studies have reported that people with OSA tend to have increased IOP values, possibly related to increased body mass index and RNFL thinning with visual field defect. The proposed pathogenesis of OSA in NTG seems to be multifactorial, mainly mechanical and vascular factors.…”

Glaucoma and its association with obstructive sleep apnea: A narrative review

“…[34] This causes decrease in the arterial oxygen (O 2 ) saturation and a rise in the carbon dioxide saturation during sleep[5] and results in transient hypoxia and increased vascular resistance in body tissues. In case of ocular tissues, this results in a reduction of ocular perfusion pressure and decreased oxygenation to the optic nerve which eventually leads to glaucomatous optic neuropathy.…”

“…In case of ocular tissues, this results in a reduction of ocular perfusion pressure and decreased oxygenation to the optic nerve which eventually leads to glaucomatous optic neuropathy. [5] It shows specific symptoms and signs such as excessive daytime sleepiness or fatigue and obesity. The prevalence of OSA in community screening is 2%-6% for moderate and above and 14% for mild form.…”