June 19, 2019
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Sleep apnea increases glaucoma progression

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Researchers found a significant correlation between severe obstructive sleep apnea and a higher risk of structural deterioration in patients with glaucoma.

In addition to its association with floppy eyelid syndrome, central serous choroidoretinopathy, retinal vein occlusions, papilledema and nonarteritic anterior ischemic optic neuropathy, obstructive sleep apnea (OSA) is a widely accepted risk factor for glaucoma, according to the study.

Researchers evaluated 32 patients who had normal tension glaucoma or primary open angle glaucoma or were categorized as glaucoma suspect. The average age at diagnosis was 50.8 ± 13.2 years, and 28 subjects were men. Twenty-four subjects were considered pre-obese, and five were obese.

The patients were stratified into two groups: no/mild OSA and moderate/severe OSA. All study subjects were followed for at least 3 years and had at least 3 consecutive reliable visual field or OCT tests.

Those with moderate/severe OSA exhibited a higher percentage of progression on visual field tests and retinal nerve fiber layer (RNFL) thickness on OCT measurements, the researchers concluded.

They also evaluated patients who were treated for OSA to determine if the treatment affected glaucoma progression. Seven were treated with continuous positive airway pressure (CPAP), and two received surgery.

According to the study, no statistically significant differences were seen in RNFL thickness or visual field tests when comparing patients who received treatment with those who did not.

Because severe OSA was linked to a higher risk of structural deterioration, the authors recommended considering possible undiagnosed severe OSA in patients with rapidly thinning RNFL or visual field deterioration despite controlled IOP. – by Nancy Hemphill, ELS, FAAO

Disclosures: The authors report no relevant financial disclosures.