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Cindi Yim, Davis Zhou, Robert Hiensch, Timothy P Fox, Albert Wu; The Effect of Obstructive Sleep Apnea and CPAP therapy on Intraocular Pressure. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5331.
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Obstructive sleep apnea (OSA) has been associated with diseases such as hypertension, diabetes mellitus type 2, cardiovascular disease, and widely varied ocular morbidity. Current studies lack consensus about the relationship between OSA, continuous positive airway pressure (CPAP) therapy, and intraocular pressure (IOP). We performed a prospective study to assess the association between OSA and CPAP therapy on evening and morning IOP.
The evening and morning IOP of 107 (N = 214 eyes) patients receiving an overnight polysomnography (PSG) study at Mount Sinai Center for Sleep Medicine was measured using rebound tonometer. Subjects were recruited and examined prior to undergoing PSG, which also included an ocular history and assessment of visual acuity. Examiners were blinded to patient medical history and OSA status. Relevant data collected during PSG included the apnea-hypoapnea index (AHI), mean oxygen saturation during wakefulness, overall diagnostic impression of OSA severity, and therapeutic pressure for those receiving CPAP. Two-tailed t-test was used to compare the difference in IOP of CPAP and non-CPAP groups. Population-averaged Generalized Estimating Equations (GEE) models were used to analyze the effect of patient demographics and comorbidities on average IOP. All calculations were performed using Python.
The mean evening IOP of the CPAP and non-CPAP groups measured before PSG was 14.28 ± 3.57 mmHg and 14.42 ± 3.58 mmHg, respectively (p = 0.8), while the mean morning IOP of the CPAP and non-CPAP groups was 14.32 ± 3.37 mmHg and 14.09 ± 3.18 mmHg, respectively (p = 0.4). Two-tailed t-test did not reveal a statistically significant difference in change in IOP overnight in CPAP and non-CPAP groups. Population-averaged GEE models revealed that the severity of OSA diagnosis (mild, moderate, severe) and having a comorbidity of congestive heart failure (CHF) were positively correlated with average IOP (p = 0.036 and p = 0.045, respectively).
CPAP therapy did not appear to affect the average IOP in patients with OSA. An increased disease severity of OSA and comorbidity of CHF appeared to be associated with increased average IOP. More research is necessary to understand how long term use of CPAP therapy for OSA may affect IOP.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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