Ocular Manifestations of Obstructive Sleep Apnea

Abstract

Study Objectives: Obstructive sleep apnea (OSA) incurs a host of systemic side effects. The eyes are particularly susceptible to both mechanical and vascular sequelae of the disease. This paper outlines the ocular manifestations of sleep apnea. The authors hope to increase awareness of the ocular complications of this common disorder and increase communication and co-management between eye-care providers and sleep specialists alike. Methods: Data were collected from PubMed and the Brown University Library Collection. Results: Twenty-two papers were included in this review to address floppy eyelid syndrome, nonarteritic anterior ischemic optic neuropathy, central serous retinopathy, retinal vein occlusion, and glaucoma. We used three meta-analyses and several cross-sectional cohort and case-control studies that investigate the aforementioned conditions and their associations with OSA. Conclusions: Hypoxia induced by nightly cessation of breathing increases patients' risk of coronary artery disease, heart failure, stroke, and other conditions. As with many maladies detrimental to vascular health, obstructive sleep apnea affects the eye and ocular adnexa. This paper summarizes the current evidence implicating OSA in these ocular maladies and highlights their proposed mechanisms. The authors describe ocular pathology which sleep specialists may encounter. We encourage more aggressive attention to ocular symptoms in patients with sleep apnea to prevent vision-threatening complications. Further research should investigate how sleep apnea treatment affects these ocular findings and identify which sleep apnea patients are most prone to developing ocular pathology. Keywords: eye diseases, obstructive sleep apnea, ophthalmology Citation: Santos M, Hofmann RJ. Ocular manifestations of obstructive sleep apnea.

Alterations in Parafoveal and Optic Disc Vessel Densities in Patients with Obstructive Sleep Apnea Syndrome

“…OSAS is a systemic disease disturbing many organs and tissues. Although there are some studies reporting the association of OSAS with glaucoma or decreased retinal nerve fiber layer (RNFL) thickness, the data regarding the ocular alterations in OSAS are limited and conflicting [6][7][8].…”

Sleep apnea and dry eye: how sleep apnea affects the eye surface

“…Environmental factors like exposure to dry air, cigarette smoke, and dust are known to exacerbate DED [24] as well as the continuous exposure to air leakage from CPAP mask in OSA patients, which is a risk factor that should not be underestimated. Studies recently showed the association of ophthalmic manifestations with OSA, which is characterized by recurrent complete or partial upper airway obstructions during sleep [25].…”

Obstructive Sleep Apnea is Related with the Risk of Retinal Vein Occlusion

“…In recent years, interesting findings between the association of OSA and glaucoma had attracted the attentions of ophthalmologists and sleeping disorder experts. 12 , 13 , 16 , 17 After this, mounting evidence on the relationships between OSA and ocular disorders were reported and the potential mechanisms were studied as well. RVO was a thrombus formation-related disease and caused by the occlusion of retinal veins.…”