Sleep Deficit and Inflammatory Markers as Combined Risk Factors for Glaucoma Progression: A Prospective Longitudinal...

Area of Science:

• Ophthalmology
• Neuroscience
• Immunology

Background:

• Glaucoma progression varies despite controlled intraocular pressure, suggesting other modifiable factors.
• Identifying contributors beyond intraocular pressure is crucial for managing neurodegeneration in glaucoma.

Purpose of the Study:

• To investigate the combined effects of sleep deficit and inflammatory cytokines on retinal nerve fiber layer (RNFL) loss in glaucoma.
• To determine if inflammation mediates the relationship between sleep and glaucoma progression.

Main Methods:

• A 24-month prospective observational study of 57 participants (controls, treated glaucoma, untreated glaucoma).
• Utilized spectral-domain OCT for RNFL assessment, validated sleep evaluations, and serial profiling of IL-6 and TNF-α.
• Employed longitudinal models to analyze independent and interactive effects of sleep and inflammation on RNFL change.

Main Results:

• Glaucoma patients exhibited significantly faster RNFL loss than controls.
• Sleep deficit correlated with increased RNFL loss in glaucoma patients, particularly in untreated cases.
• Each hour of sleep deficit was linked to faster RNFL loss (0.09-0.11 μm/year).

Conclusions:

• Sleep deficit and inflammatory cytokines are parallel, independent risk factors for glaucoma progression.
• Inflammation does not mediate the association between sleep deficit and RNFL loss.
• Integrating sleep and inflammatory assessments may improve personalized glaucoma risk stratification beyond intraocular pressure.