Abstract
Purpose :
While sleep apnea has been linked as a potential risk factor for several eye diseases, the relationship between obstructive sleep apnea and diabetic retinopathy has been inconsistent. We performed a cross-sectional study to explore the association between obstructive sleep apnea and diabetic retinopathy in the elderly US California (CA) Medicare population.
Methods :
This study was conducted among US CA Medicare beneficiaries using the 2019 part B carriers claims databases attained from the Centers for Medicare and Medicaid Services (CMS). The inclusion criteria were patients who were residing in CA during 2019, were 65 years of age or older, had both Medicare Part A and Part B coverages, and had at least one Part B claim in 2019. The exposure was obstructive sleep apnea (OSA) and the outcome of interest was diabetic retinopathy (DR), both of which were defined by the corresponding ICD-10-CM diagnosis codes in any claims. Potential confounders included age, sex, race/ethnicity, and Charlson Comorbidity Index (CCI) scores. Unadjusted associations were performed using chi-squared tests. Multivariable logistic regression models were utilized to assess the adjusted association by controlling for all aforementioned potential confounders.
Results :
Among 2,717,346 CA Medicare beneficiaries who met inclusion criteria, 27.9% (759,062) were 65-69 years of age, 56.8% (1,544,479) were female, 62.8% (1,706,807) were white, 4.3% (117,856) were black, 12.8 (346,723) were Asian, 15.9% (430,597) were Hispanic, and 65.6% had a CCI score of 1 or more. The overall prevalence of OSA was 5.9% (161,350), and the overall prevalence of DR was 3.3% (89,693). Those with OSA had an increased odds of DR (adjusted OR=1.54; 95% CI:1.51, 1.58; p<0.001) compared to those without OSA.
Conclusions :
Our study identified a statistically significant association between obstructive sleep apnea and diabetic retinopathy in the senior CA Medicare population. This finding indicates the need for further studies to analyze the impacts of OSA on DR, such as the severity and development of DR subtypes.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.