Relationship Between Obstructive Sleep Apnea and the Presence and Severity of Diabetic Retinopathy

Abstract

The findings suggest an increased risk of DR, proliferative DR, and diabetic macular edema in patients with severe OSA. Ophthalmologists following these patients should be aware of this association to better manage ocular sequelae of diabetes.

The associations of objectively measured sleep duration and sleep disturbances with diabetic retinopathy

“…Longitudinal data have also shown that OSA is a risk factor for DR progression and that treatment with continuous positive airway pressure reduced this risk [6]. Other studies have also found that more severe OSA is associated with DME [27]. While we did show that moderate OSA and AHI were associated with moderate DR and VTDR, we did not find any significant associations between mod OSA or AHI and DME.…”

Obstructive sleep apnoea

“…Oxygen desaturation was significantly inversely related to microalbuminuria, microvascular complications, retinopathy, and HbA1c. In another study, Change et al retrospectively evaluated 317 people with DR and OSA, with review of polysomnography, coding and medical records [68]. After adjustment, an association was seen between DR and severe OSA (OR: 2.18, 95% confidence CI: 1.14-4.18, P = 0.019).…”

“…More recently, Leong et al performed a systematic review and meta-analysis of the effect of OSA on DR and maculopathy [72]. In the systematic review, they included 16 studies: one longitudinal, the rest cross-sectional, and all the studies listed above were included, except for the two which were published later [68,70]. Three studies were included in the meta-analysis.…”

No association between sleep apnoea and macular telangiectasia type 2 and its markers of severity and progression: a case–control study and retrospective cohort study

“…Obstructive Sleep Apnoea (OSA) is characterized by the episodic collapse of the upper airway during sleep resulting in repeated apnoeic episodes with concomitant increases in arterial blood pressure and reductions in blood oxygen saturation levels. [13][14][15] More broadly, OSA has been implicated as a risk factor in other ophthalmic conditions including glaucoma, nonarteritic anterior ischemic optic neuropathy, central serous chorioretinopathy and floppy eyelid syndrome. 8 Several comorbidities, including an increased prevalence of hypertension, obesity and cardiovascular disease are common within the OSA population.…”

“…12 Recent studies have explored potential relationships between OSA and other retinal disease, specifically diabetic retinopathy where OSA has been reported as an independent risk factor in the progression of diabetic retinopathy. [13][14][15] More broadly, OSA has been implicated as a risk factor in other ophthalmic conditions including glaucoma, nonarteritic anterior ischemic optic neuropathy, central serous chorioretinopathy and floppy eyelid syndrome. 16 Although the exact pathogenesis of MacTel remains unclear, it has been postulated that Müller cell dysfunction may play a critical role throughout the disease process.…”