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Obstructive sleep apnea increases risk for glaucoma
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Researchers found that obstructive sleep apnea is a risk factor for glaucoma, according to a recently published study.
Shulin Liu, MD, and colleagues reported in the Journal of Glaucoma that they used a meta-analysis and literature review to identify six primary studies involving nearly 2.3 million participants.
The paper outlined the inclusion criteria: obstructive sleep apnea (OSA) was diagnosed by physicians, polysomnography or respiratory polygraphy; the researchers selected only cohort or case-control studies; and the relationship between OSA and risk for glaucoma in terms of odds ratio, relative risk and hazard risk was available.
Compared with the non-OSA group, OSA was associated with more frequent glaucoma, the authors said. Chinese OSA patients had a higher risk of developing glaucoma than people in other countries.
The researchers also suggested that female and younger OSA patients may have a higher risk for glaucoma.
The cohort studies exhibited that OSA was associated with a 1.43-fold increased risk of glaucoma, and case-control studies showed a 2.46-fold increased risk, according to researchers.
Researchers also found a 72% increase in the risk when the endpoint contained greater than one type of glaucoma.
The researchers concluded: “On the basis of our meta-analysis of three case-control and three cohort studies, OSA was a risk factor for glaucoma, especially in China, but may not increase the risk of OAG.” – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
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Blair Lonsberry, OD, FAAO
Obstructive sleep apnea results in sleep-related bouts of hypoxia followed by reperfusion. Its relationship with glaucoma has been mixed, with reports supporting and negating the relationship.
The authors searched the literature for references related to obstructive sleep apnea (OSA) and all forms of glaucoma. In their final analysis they determined that OSA was a risk factor for glaucoma. Chinese, female and younger OSA patients may have a higher risk for glaucoma.
The mechanism by which this happens is unclear, and further studies are needed to explore the mechanisms that link OSA with glaucoma. Proposed mechanisms include inflammation secondary to hypoxia and increased intracranial pressure with resulting decreased cerebral perfusion pressure and altered blood supply to the optic nerve.
Treatment utilizing continuous positive airway pressure (CPAP) is thought to increase intraocular pressure and potentially increase glaucoma risk. The authors report that treatment did not increase the risk of glaucoma. However, these results were based on few studies and need to be interpreted with caution.
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