CPAP Use and Retinal Disease Risk in Obstructive Apnea: A Cohort Study

Area of Science:

• Ophthalmology
• Sleep Medicine
• Cardiovascular Research

Background:

• Obstructive sleep apnea (OSA) is linked to systemic inflammation and vascular dysfunction, contributing to retinal disease.
• Mechanisms like intermittent hypoxia in OSA are implicated in the pathogenesis of various retinal conditions.

Purpose of the Study:

• To evaluate the effectiveness of continuous positive airway pressure (CPAP) therapy in reducing the incidence of retinal diseases in adults with OSA.
• To assess the impact of CPAP on diabetic retinopathy (DR), age-related macular degeneration (AMD), retinal vein occlusion (RVO), and central serous chorioretinopathy (CSC) in overweight OSA patients.

Main Methods:

• A retrospective cohort study utilizing the TriNetX Research Network.
• 101,754 adult patients with OSA and a BMI of 25.0–30.0 kg/m² were analyzed after 1:1 propensity score matching.
• Incidence of DR, AMD, RVO, and CSC was compared between patients receiving CPAP therapy and those who did not.

Main Results:

• CPAP use was associated with a statistically significant reduction in the incidence of diabetic retinopathy (DR) (3.2% vs. 3.4%) and age-related macular degeneration (AMD) (2.1% vs. 2.3%).
• No significant differences in the incidence of retinal vein occlusion (RVO) or central serous chorioretinopathy (CSC) were observed between the groups.
• The relative risk reductions for DR and AMD were 0.922 (p=0.016) and 0.906 (p=0.018), respectively.

Conclusions:

• CPAP therapy shows a potential protective effect against specific retinal complications, particularly DR and AMD, in adults with OSA.
• Findings support existing evidence linking CPAP to improved retinal microvascular health.
• Further prospective studies are warranted to confirm these results, considering factors like CPAP adherence and OSA severity.