June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Optic disc measures in obstructive sleep apnoea: a community-based study of middle-aged and older adults
Author Affiliations & Notes
  • David A Mackey
    University of Western Australia/Lions Eye Institut, Subiaco, Western Australia, Australia
  • Paul Sanfilippo
    Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
  • Michael Hunter
    School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
    Busselton Population Medical Research Institute,, Busselton, Western Australia, Australia
  • Alan James
    Sir Charles Gairdner Hospital, Department of Pulmonary Physiology and Sleep Medicine/West Australian Sleep Disorders Institute, Perth, Western Australia, Australia
  • Seyhan Yazar
    University of Western Australia/Lions Eye Institut, Subiaco, Western Australia, Australia
  • Samantha Lee
    University of Western Australia/Lions Eye Institut, Subiaco, Western Australia, Australia
  • Footnotes
    Commercial Relationships   David Mackey, None; Paul Sanfilippo, None; Michael Hunter, None; Alan James, None; Seyhan Yazar, None; Samantha Lee, None
  • Footnotes
    Support  NHMRC
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2737. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Pevious findings on the link between obstructive sleep apnoea (OSA) and increased glaucoma risk
have been inconsistent. In a cohort of community-based study of middle-aged and older adultswe explored for
differences in optic disc measures that may resemble preclinical glaucomatous changes in relation to OSA
status and severity.

Methods : Older adults underwent an at-home sleep study to obtain measures of their apnoea-hypopnoea
index (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), or
severe OSA (AHI>30). At a six-year follow-up visit, the optic discs of both eyes were imaged using spectral
domain 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 to
examine 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.

Results : 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 and
26 (2%) with severe OSA. In the multivariate analysis, participants with severe OSA had thinner RNFL
superotemporally 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 superotemporal
RNFL by 0.9μm. There was no association between sleep apnoea measures and minimum rim width. Ten
participants had a previous diagnosis of glaucoma, 5 of whom had OSA based on their sleep study.

Conclusions : Our findings do not provide strong evidence of a link between measures of OSA and the optic
disc. However, the association between increased OSA severity and thinner superotemporal RNFL has been
reported consistently in previous studies and thus warrants further evaluation.

This is a 2020 ARVO Annual Meeting abstract.

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