Abstract
Purpose :
Obstructive sleep apnea (OSA) has been associated with the development and worsening of many chronic systemic diseases. More recently, OSA has also been proposed as a risk factor for glaucoma by leading to blood pressure and intraocular pressure (IOP) fluctuations, increased intracranial pressure, and hypoxia-induced neural damage. In this study, we evaluated whether a concomitant diagnosis of OSA affected the rates of structural loss in subjects with glaucoma.
Methods :
This was a retrospective cohort study using data from the Duke Ophthalmic Registry (DOR). Patients with a concomitant diagnosis of obstructive sleep apnea (OSA) and primary open angle glaucoma (POAG) or suspects of glaucoma at baseline were identified. Included eyes had at least 5 reliable peripapillary retinal nerve fiber layer (RNFL) OCT scans during a minimum follow-up of 12 months. A random sample of eyes with POAG or suspects, but no OSA, was selected from the cohort as the control group, matched 2:1 by mean intraocular pressure (IOP) during follow-up, follow-up time, and baseline age and RNFL thickness. Univariable and multivariable mixed-effects models were used to compare slopes of RNFL change between the OSA and control groups over time, while adjusting for potential confounding factors.
Results :
The study included 365 eyes of 202 subjects with OSA and POAG or suspects and a matched sample of 730 eyes of 578 subjects with POAG or suspects. Mean follow-up time was 5.9±1.4 years, with an average of 6.0±1.2 OCT tests in the OSA group and 6.1±1.4 OCT tests in the control group (P=0.885). Mean rate of RNFL change was -0.66±0.47 µm/year versus -0.71±0.43 µm/year in OSA and control groups, respectively (P=0.075). After controlling for baseline RNFL thickness, mean IOP, race, gender, baseline age, CCT and follow up time, no statistically significant difference was observed between the RNFL slopes in the OSA and control groups (P=0.378).
Conclusions :
We were not able to observe a statistically significant difference between mean rates of RNFL loss among eyes of glaucoma or suspect patients with versus without OSA.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.