Sleep and Breathing

, Volume 20, Issue 4, pp 1145–1154 | Cite as

The association between ophthalmologic diseases and obstructive sleep apnea: a systematic review and meta-analysis

  • Leh-Kiong Huon
  • Stanley Yung-Chuan Liu
  • Macario Camacho
  • Christian GuilleminaultEmail author
Sleep Breathing Physiology and Disorders • Review



The purpose of this study was to evaluate the association between obstructive sleep apnea (OSA) and ophthalmologic diseases, specifically glaucoma, nonarteritic anterior ischemic optic neuropathy (NAION), retinal vein occlusion (RVO), central serous chorioretinopathy (CSR), and floppy eyelid syndrome (FES), by performing a systematic review and meta-analysis of published studies.


PubMed, Embase, and Scopus databases were searched for observational studies on OSA and its association with select ophthalmologic diseases. Data was pooled for random-effects modeling. The association between OSA and ophthalmologic diseases was summarized using an estimated pooled odds ratio with a 95 % confidence interval.


Relative to non-OSA subjects, OSA subjects have increased odds of diagnosis with glaucoma (pooled odds ratio (OR) = 1.242; P < 0.001) and floppy eyelids syndrome (pooled OR = 4.157; P < 0.001). In reverse, the overall pooled OR for OSA was 1.746 (P = 0.002) in the glaucoma group, 3.126 (P = 0.000) in the NAION group, and 2.019 (P = 0.028) in the CSR group. For RVO, one study with 5965 OSA patients and 29,669 controls demonstrated a 1.94-fold odds increase in OSA patients.


Our results suggest significant associations between OSA and glaucoma, NAION, CSR, and FES. Screening for OSA should be considered in patients with glaucoma, NAION, CSR, or FES.


Obstructive sleep apnea Glaucoma Floppy eyelids Nonarteritic anterior ischemic optic neuropathy Central serous chorioretinopathy 



This study was led by Dr. Leh-Kiong Huon while she was a visiting scholar in Sleep Surgery and Sleep Medicine at Stanford University School of Medicine. No funding was received for this research. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speaker’s bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements,) or non-financial interest (personal or professional relationships, affiliations, and knowledge or beliefs) in the subject matter or materials discussed in this manuscript. As this is a bibliographic research, it was considered “exempt” from IRB approval.

Compliance with ethical standards


No funding was received for this research.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Leh-Kiong Huon
    • 1
    • 2
    • 3
    • 4
  • Stanley Yung-Chuan Liu
    • 4
  • Macario Camacho
    • 3
    • 4
    • 5
  • Christian Guilleminault
    • 3
    • 6
    Email author
  1. 1.Department of Otolaryngology, Head and Neck SurgeryCathay General HospitalTaipeiTaiwan
  2. 2.School of MedicineFu Jen Catholic UniversityTaipeiTaiwan
  3. 3.Division of Sleep Medicine, Department of Psychiatry and Behavioral SciencesStanford University Medical CenterStanfordUSA
  4. 4.Division of Sleep Surgery, Department of Otolaryngology-Head & Neck SurgeryStanford University Medical CenterStanfordUSA
  5. 5.Division of Sleep Surgery and Medicine, Otolaryngology-Head and Neck SurgeryTripler Army Medical CenterHonoluluUSA
  6. 6.Stanford University Sleep Medicine DivisionRedwood CityUSA

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