Is Obstructive Sleep Apnea Associated With Progressive Glaucomatous Optic Neuropathy?

Area of Science:

• Ophthalmology
• Pulmonology
• Sleep Medicine

Background:

• Obstructive sleep apnea syndrome (OSAS) is a common condition characterized by repeated episodes of upper airway collapse during sleep.
• Glaucoma is a progressive optic neuropathy for which OSAS is a potential risk factor.
• Understanding the relationship between OSAS and glaucoma progression is crucial for patient management.

Purpose of the Study:

• To investigate the association between obstructive sleep apnea syndrome (OSAS) and the progression of glaucoma.
• To determine if the severity of OSAS correlates with the rate of visual field (VF) loss in glaucoma patients.

Main Methods:

• Retrospective study of patients diagnosed with both open-angle glaucoma and OSAS between 2010 and 2016.
• Inclusion criteria: glaucomatous optic neuropathy, VF loss, ≥5 reliable VFs, ≥2 years follow-up, and polysomnography (PSG) within 12 months of final VF.
• Analysis included comparing PSG parameters (AHI, SpO2) between progressors and non-progressors and assessing correlations with VF loss rates.

Main Results:

• Of 141 identified patients, 25 (mean age 67.9 years) were enrolled, with varying OSAS severity (8 mild, 8 moderate, 9 severe).
• Eleven eyes (44%) were classified as progressors, showing more severe baseline VF loss (P=0.03).
• No significant differences were found in age, follow-up duration, intraocular pressure, ocular perfusion pressure, AHI, BMI, or SpO2 between progressors and non-progressors. AHI did not correlate with VF loss rates.

Conclusions:

• The findings do not support a relationship between obstructive sleep apnea syndrome (OSAS) and the progression of glaucoma.
• No significant correlation was observed between the severity of OSAS and the rate of visual field loss in this patient cohort.