Prevalence of glaucoma in patients with obstructive sleep apnoea—a cross-sectional case-series

Re, Bendel; Kaplan, Joseph; Heckman, Michael G.; Pa, Fredrickson; Sc, Lin

doi:10.1038/sj.eye.6702846

Cited by 94 publications

(61 citation statements)

References 17 publications

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“…37 The low prevalence in ours and Geyer et al's studies could be the effect of CPAP treatment. Whereas, most other studies reporting higher prevalence of glaucoma in OSAHS (7.2-27%) 3,[6][7][8]28,38 have investigated patients at time of referral for polysomnography and before initiation of therapy; Geyer recruited patients earlier diagnosed with OSAHS and possibly receiving treatment. The authors, however, have not mentioned the treatment status of the OSAHS patients in their report.…”

Section: Discussionmentioning

confidence: 99%

Ocular findings in sleep apnoea patients using continuous positive airway pressure

Kadyan

Asghar²,

Dowson

et al. 2009

Eye

107

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Purpose To describe ocular findings in patients with established obstructive sleep apnoea hypopnoea syndrome (OSAHS) using continuous positive airway pressure (CPAP). Methods One hundred and fifteen referrals investigated for OSAHS were included. Patients with OSAHS were compared with those with normal sleep study controls. Subgroup analysis for CPAP users and nonusers was also carried out. Results OSAHS patients (n ¼ 89) compared with the controls (n ¼ 26) had higher ocular irritation symptoms (Po0.001), abnormal tear break-up time (Po0.05) with increased upper (Po0.001) and lower (Po0.001) lid laxity. Floppy eyelid syndrome (FES) was noted in 31.5% (28/89) OSAHS patients vs 3.8% (1/26) controls (P ¼ 0.005). Open angle glaucoma prevalence in OSAHS patients (3/89, 3.4%) was similar to the controls (1/26, 3.8%) (P ¼ 0.92). Sixty-seven (75.3%) OSAHS patients were using CPAP (average duration: 19.6 ± 15.3 months). All CPAP users maintained a supine sleep posture to prevent mask edge leaks. A fifth of CPAP users (14/67) had experienced earlier episodes of conjunctivitis secondary to leaks. CPAP users had similar upper and lower lid laxity (P ¼ 0.746 and 0.633) to non-CPAP users, but a better tear film (P ¼ 0.029) and less ocular irritation (P ¼ 0.134). Conclusion OSAHS patients showed increased ocular irritation, abnormal tear film, lid laxity, and FES. The prevalence of glaucoma in our series was similar to normal population data of 2%, P ¼ 0.429, and may relate to use of CPAP in majority of the patients. More stable tear film in CPAP users was probably secondary to the supine sleep postures necessarily adopted with CPAP use.

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Section: Discussionmentioning

confidence: 99%

Ocular findings in sleep apnoea patients using continuous positive airway pressure

Kadyan

Asghar²,

Dowson

et al. 2009

Eye

107

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“…According to some reports, the prevalence of primary open-angle glaucoma is increased in patients with OSAS. 7,8 Further, examination by perimetry revealed that the retinal nerve fiber layer of some OSAS patients with a normal visual field and no obvious optic neuropathy tended to be thin, 9 indicating that OSAS may affect the physiological structure of the optic nerve.…”

Section: Introductionmentioning

confidence: 99%

Retinal and choroidal thickness evaluation by SD-OCT in adults with obstructive sleep apnea-hypopnea syndrome (OSAS)

Chen

Wang

Zhang

et al. 2014

Eye

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Objective To assess the macular retina and choroidal thickness change in patients with obstructive sleep apnea-hypopnea syndrome (OSAS) with no significant symptoms and pathological changes in the fundus using spectral domain-optical coherence tomography. Methods This prospective, observational case-control study consisted of 53 eyes of 53 patients with OSAS and 12 eyes of 12 age-matched controls. Macular and choroidal thicknesses were measured by optical coherence tomography. Results The foveal and nasal macular thicknesses were significantly different between four groups (P ¼ 0.001, P ¼ 0.016). The foveal thickness of the control group was significantly thinner than that of the severe group (P ¼ 0.000). The nasal macular thickness of the control group was significantly thinner than that of the severe group (P ¼ 0.008). A significant correlation was found between oxygen desaturation index (ODI) and macular center thickness (r ¼ 0.357, R 2 ¼ 0.127, P ¼ 0.004), with an ODI coefficient of 0.457 (P ¼ 0.004). Similarly, a significant correlation was found between ODI and nasal macular thickness (r ¼ 0.265, R 2 ¼ 0.070, P ¼ 0.033), with an ODI coefficient of 0.233 (P ¼ 0.033). The subfoveal choroidal thickness was significantly different among the groups (F ¼ 3.657, P ¼ 0.017). The subfoveal choroidal thickness of the severe group was significantly thinner than that of the control group, mild group, and moderate group (P ¼ 0.023, 0.006, and 0.036, respectively). The choroidal thickness 1 mm nasal to the fovea was significantly different between the groups after correcting for age and diopter (F ¼ 3.411, P ¼ 0.023). The choroidal thickness 1 mm nasal to the fovea was significantly thinner in the severe group compared with the control group and mild group (P ¼ 0.013 and 0.010, respectively). Choroidal thickness was significantly correlated with diopter (r ¼ 0.520, R 2 ¼ 0.270, Po0.001), with a coefficient of 0.327 (Po0.001), and with ODI (r ¼ 0.520, R 2 ¼ 0.165, P ¼ 0.001), with a coefficient of À 0.370 (P ¼ 0.001). Conclusions OSAS patients showed decreased foveal and nasal macular thickness, similar to the subfoveal and nasal choroidal thickness. These findings suggest that, because of intermittent hypoxia, OSAS might change the retinal and choroidal blood supply.

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“…Examination of published reports on the link between glaucoma and sleep apnea has indicated that the prevalence of glaucoma among patients with sleep apnea ranges from 2% to 7.2% [11,14,15]. A recent cross-sectional case series suggested that as much as 27% of patients with moderate to severe sleep apnea might have glaucoma [66]. There is a lack of consensus whether the prevalence of glaucoma among patients with sleep apnea is greater than observed in the general population [15].…”

Section: Sleep Apnea and Glaucoma -Is There An Association?mentioning

confidence: 97%

Sleep Apnea and Glaucoma – Greater Risk for Blacks?

Zizi¹,

Mallick²,

Dweck³

et al. 2011

Glaucoma - Basic and Clinical Concepts

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Prevalence of glaucoma in patients with obstructive sleep apnoea—a cross-sectional case-series

Cited by 94 publications

References 17 publications

Ocular findings in sleep apnoea patients using continuous positive airway pressure

Ocular findings in sleep apnoea patients using continuous positive airway pressure

Retinal and choroidal thickness evaluation by SD-OCT in adults with obstructive sleep apnea-hypopnea syndrome (OSAS)

Sleep Apnea and Glaucoma – Greater Risk for Blacks?

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