Primary Open-Angle Glaucoma Is Associated with Sleep Apnea Syndrome

Abstract

Introduction: The etiology of primary open-angle glaucoma remains unclear. Various risk factors, including vascular abnormalities, have been associated with this disease. Sleep-associated diseases, like sleep apnea syndrome, might also represent a risk factor. Sleep apnea syndrome is characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of cardiovascular and neurological sequelae. In this study, we determined the prevalence of sleep apnea syndrome in primary open-angle glaucoma patients. Methods: Overnight transcutaneous finger oximetry was performed in 30 consecutive patients having primary open-angle glaucoma. We assessed the oximetry disturbance index during night sleep, a parameter used to diagnose sleep apnea syndrome and to grade its severity. Results: Sleep apnea syndrome was more prevalent among primary open-angle glaucoma patients compared to normal historic controls of the same age and sex distribution (χ² = 9.35, d.f. = 3, p < 0.025). The oximetry disturbance index grade was significantly larger in the primary open-angle glaucoma group compared to normal controls (U = 3,352, p = 0.01). According to the oximetry disturbance index, 20% (6/30) of primary open-angle glaucoma patients had sleep apnea syndrome. Conclusion: Primary open-angle glaucoma is associated with sleep apnea syndrome. Early recognition and treatment of sleep apnea syndrome are important to avoid cardiovascular and neurological complications.

Ocular findings in sleep apnoea patients using continuous positive airway pressure

“…Ocular associations reported with OSAHS include floppy eyelid syndrome (FES), blepharoptosis, lower lid ectropion, blepharochalasis, eyelash ptosis, lacrimal gland prolapse, papillary conjunctivitis, filamentary or infectious keratitis, recurrent corneal erosion, keratoconus, optic neuropathy, papilloedema, and glaucoma. [3][4][5][6][7][8][9][10][11][12][13] Specific disease management uses the basic concept of gentle pressurisation of the upper airway during sleep to prevent the collapse of the pharynx. Continuous positive airway pressure (CPAP) administered through a nasal or face mask has remained the mainstay of treatment in OSAHS since its advent in the 1980s.…”

Treating obstructive sleep apnoea syndrome: does it improve visual field changes?

“…1 OSAS has been reported in association with primary open angle glaucoma. 1 Geyer et al 2 found equal prevalence of glaucoma in OSAS as in the general population. Ophthalmic findings in OSAS are floppy eyelid syndrome, 3,4 keratoconus, 5 papilloedema, 6 and ischaemic optic neuropathy.…”

“…Complications associated with alloplastic implants (silicone/silastic/supramid) are rare. 1 However, they can occur some considerable time after surgery. 2 A 36-year-old Caucasian male presented with complete lower eyelid retraction 3 years after silicone sheet orbital floor implant.…”

The Assessment of Sleep Apnoea as a Risk Factor in Glaucoma

“…Majon DS et al, [5] diagnosed sleep apnoea in 20% POAG patients by using transcutaneous finger oxymetry by calculating the oxygen disturbance index. In our study, the diagnosis of sleep apnoea was based on a combination of the positive questionnaire responses and the positive polysomnography results.…”