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Samantha SY Lee, Nigel McArdle, Paul Sanfilippo, Seyhan Yazar, Peter Eastwood, Alex W Hewitt, David A Mackey; Associations between optic disc measures and obstructive sleep apnoea in young adults. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1957. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Obstructive sleep apnoea (OSA) is linked to increased glaucoma risk. Even though OSA mainly affects middle-aged and older adults, recent studies show that the condition is also common in young adults. However, little is known about associations between OSA and glaucoma-related optic disc parameters in young adults. We therefore explored associations between measures of OSA and the optic disc in young adults.
Participants of the longitudinal Western Australian Pregnancy Cohort (Raine) Study underwent an ophthalmic examination that included spectral-domain optical coherence tomography (SD-OCT) imaging, and measurements of intraocular pressure (IOP), axial length, and refractive error. The primary measures of the SD-OCT imaging were neuroretinal rim (NRR) area, vertical and horizontal widths, as well as peripapillary retinal nerve fibre layer (RNFL) thickness. An overnight sleep study (polysomnography [PSG]) was conducted to obtain the apnoea−hypopnoea index (AHI). A diagnosis of OSA was made based on an AHI value of ≥ 5 events per hour. Regression models were used to explore the optic disc measures of those with OSA in comparison to those without OSA, and the association between AHI and optic disc measures.
A total of 849 participants (49.8% males; 19−22 years old) had complete SD-OCT and PSG data for analysis. The median AHI was 2.2 events per hour (interquartile range: 1.0−4.4). Based on the AHI, 178 participants (21.0%) had OSA, comprising 150 with mild OSA (AHI 5−14) and 28 with moderate or severe OSA (AHI ≥15). Participants with OSA had on average thinner peripapillary RNFL at the inferiotemporal and superiotemporal segments (p=0.031 and 0.008 respectively) compared to those without OSA. Additionally, higher AHI was associated with thinner RNFL at the superiotemporal segment (p=0.007). These findings remained significant after adjustments for IOP, axial length, CCT, and refractive error.
Our findings that OSA may be associated with preclinical changes to the optic disc in young adults suggest that an increased glaucoma risk may already be present in those with OSA since an early age. Long term follow-ups of this cohort will allow us to document further optic disc changes in relation to PSG parameters and explore for associations with future glaucoma diagnosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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