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Daniel Wang, Alexander Barash; Association of Obstructive Sleep Apnea with Retinal Vein Occlusion: A systematic Review and Meta-Analysis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1315.
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Obstructive sleep apnea (OSA) is a chronic medical disorder that is increasingly recognized as an important cause of medical morbidity globally. OSA has been implicated with a variety of ophthalmological conditions such as floppy eyelid syndrome, glaucoma, and non-arteritic ischemic optic neuropathy. Retinal vein occlusion (RVO) is the second most common vascular disorder affecting the retina and shares common risk factors similar to sleep apnea. Previous studies suggest an association between retinal vein occlusion and obstructive sleep apnea. In this present study, we aimed to systematically review and critically analyze the published literature in order to investigate the relationship between the two entities.
A systematic literature review of the English literature databases (Pubmed/Embase, Medline, and Scopus) applying a general search strategy was performed of all published literature up to November 2019. Articles of interest were restricted to studies that examined the relationship between obstructive sleep apnea and retinal vein occlusion. A subsequent meta-analysis of the included studies using prevalence data in an untransformed pooled proportion analysis format was conducted.
A total of six individual studies from six different countries that met the eligible review criteria were identified. Three studies that examined the prevalence of OSA in patients with newly diagnosed retinal vein occlusion diagnosis indicates an association between OSA and RVO (proportion, 0.507; 95% CI, 0.262-0.751). Three studies that investigated the prevalence of retinal vein occlusion in newly diagnosed OSA patients suggests that OSA may be an independent risk factor for RVO (proportion, 0.005; 95% CI, -0.005, 0.016).
A review of the published literature suggests an association between OSA and RVO. OSA may be a player in the pathogenesis of RVO in patients with no comorbid risk factors such as hypertension and diabetes. Although OSA may not necessarily be a separately defined risk factor for RVO, OSA may present as an entity that is frequently associated with RVO. Screening of at-risk RVO patients for OSA is pertinent to prevent associated medical morbidity in these individuals.
This is a 2020 ARVO Annual Meeting abstract.
Flow chart of literature review to identify eligible studies
Table of published literature included in review
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