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Jacob Thomas, Shaam Mahasneh, Jess T. Whitson; Glaucoma and Obstructive Sleep Apnea. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4468.
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To compare the clinical characteristics of patients with and without obstructive sleep apnea (OSA) among primary open angle glaucoma (POAG) and glaucoma suspect patients.
A retrospective case control study was conducted by performing a computer database search of patient records based on International Classification of Disease 9 (ICD-9) codes for POAG, glaucoma suspect and obstructive sleep apnea from 2001-2010. This list was cross-referenced with Current Procedural Terminology (CPT) codes for optical coherence tomography (OCT) of the optic nerve and polysomnography. The experimental groups consisted of POAG and glaucoma suspect patients with OSA. These groups were compared to age, race and gender matched control groups consisting of POAG and glaucoma suspect patients without OSA. Differences between the groups were considered significant if p<.05 with the Student’s t-test and Fisher’s exact test.
There were 28 POAG and 68 glaucoma suspect eyes in the experimental groups. When compared to the control groups, there were no significant demographic differences. Diabetes was significantly more prevalent among OSA patients in the POAG (p<0.01) and glaucoma suspect (p=0.04) groups. POAG patients with OSA were more likely to be pseudophakic (p=0.04); otherwise, there was no significant difference in ocular diagnoses between those with and without OSA. There was no significant difference between the control and experimental groups with regard to mean visual acuity, refractive error, central corneal thickness (CCT), cup-to-disc ratio, OCT retinal nerve fiber layer thickness (RNFL) or visual field mean deviation (MD). Glaucoma suspects with OSA had a significantly higher pattern standard deviation (PSD) (p=0.024); this was not observed among those with OSA and POAG. Among the POAG and glaucoma suspect groups, there was no significant difference in the mean number of medications, laser trabeculoplasty treatments or incisional surgeries between those with and without OSA.
POAG or glaucoma suspect patients with OSA have a significantly increased prevalence of diabetes and visual field PSD defects in subsets of patients. However, among POAG patients and glaucoma suspects, those with and without OSA have a similar demographic profile, visual field MD, RNFL thickness and therapeutic requirements.
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