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David A Mackey, Paul Sanfilippo, Michael Hunter, Alan James, Seyhan Yazar, Samantha Lee; Optic disc measures in obstructive sleep apnoea: a community-based study of middle-aged and older adults. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2737.
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Pevious findings on the link between obstructive sleep apnoea (OSA) and increased glaucoma riskhave been inconsistent. In a cohort of community-based study of middle-aged and older adultswe explored fordifferences in optic disc measures that may resemble preclinical glaucomatous changes in relation to OSAstatus and severity.
Older adults underwent an at-home sleep study to obtain measures of their apnoea-hypopnoeaindex (AHI), minimum oxygen saturation level, and sleep time with oxygen saturation level below 90%.Participants were grouped into no OSA (AHI <5 events per hour), mild (AHI 5−15), moderate (AHI 16−30), orsevere OSA (AHI>30). At a six-year follow-up visit, the optic discs of both eyes were imaged using spectraldomain optic coherence tomography to measure the Bruch’s membrane opening minimum rim widths (BMOMRW)and retinal nerve fibre layer (RNFL) thicknesses. Generalised Estimating Equations were used toexamine the effect of OSA and its related parameters on optic disc measures, with corrections for age, sex,body mass index, and ethnicity in the models.
A total of 865 participants (52−73 years; 45% male) completed the sleep study and OCT imaging.Based on the AHI, 411 participants (47.5%) had OSA, including 92 (11% of total sample) with moderate and26 (2%) with severe OSA. In the multivariate analysis, participants with severe OSA had thinner RNFLsuperotemporally than those without OSA or with mild OSA (Estimate= 13μm, p<0.001 and Estimate= 11μm,p=0.001, respectively). Additionally, higher AHI was each associated with thinner superiotemporal RNFL(p=0.009) such that every 5 events per hour increase in AHI was associated with thinner superotemporalRNFL by 0.9μm. There was no association between sleep apnoea measures and minimum rim width. Tenparticipants had a previous diagnosis of glaucoma, 5 of whom had OSA based on their sleep study.
Our findings do not provide strong evidence of a link between measures of OSA and the opticdisc. However, the association between increased OSA severity and thinner superotemporal RNFL has beenreported consistently in previous studies and thus warrants further evaluation.
This is a 2020 ARVO Annual Meeting abstract.
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