The association between ophthalmologic diseases and obstructive sleep apnea: a systematic review and meta-analysis
- 850 Downloads
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.
KeywordsObstructive 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.
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.
- 5.Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, D’Agostino RB, Newman AB, Lebowitz MD, Pickering TG (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 283(14):1829–1836CrossRefPubMedGoogle Scholar
- 7.Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Nieto FJ, O’Connor GT, Boland LL, Schwartz JE, Samet JM (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163(1):19–25. doi: 10.1164/ajrccm.163.1.2001008 CrossRefPubMedGoogle Scholar
- 19.Casas P, Ascaso FJ, Vicente E, Tejero-Garces G, Adiego MI, Cristobal JA (2013) Retinal and optic nerve evaluation by optical coherence tomography in adults with obstructive sleep apnea-hypopnea syndrome (OSAHS). Graefes Arch Clin Exp Ophthalmol 251(6):1625–1634. doi: 10.1007/s00417-013-2268-9 CrossRefPubMedGoogle Scholar
- 33.Li J, McGwin G Jr, Vaphiades MS, Owsley C (2007) Non-arteritic anterior ischaemic optic neuropathy and presumed sleep apnoea syndrome screened by the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ). Br J Ophthalmol 91(11):1524–1527. doi: 10.1136/bjo.2006.113803 CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Aptel F, Khayi H, Pepin JL, Tamisier R, Levy P, Romanet JP, Chiquet C (2015) Association of nonarteritic ischemic optic neuropathy with obstructive sleep apnea syndrome: consequences for obstructive sleep apnea screening and treatment. JAMA Ophthalmol 133(7):797–804. doi: 10.1001/jamaophthalmol.2015.0893 CrossRefPubMedGoogle Scholar
- 55.Boonyaleephan S (2008) Bilateral acute onset myopia and angle closure glaucoma after oral topiramate: a case report. J Med Assoc Thail 91(12):1904–1907Google Scholar
- 60.Aptel F, Chiquet C, Tamisier R, Sapene M, Martin F, Stach B, Grillet Y, Levy P, JL P, Sleep Registry of the French Federation of Pneumology Paris F (2014) Association between glaucoma and sleep apnea in a large French multicenter prospective cohort. Sleep Med 15(5):576–581. doi: 10.1016/j.sleep.2013.11.790 CrossRefPubMedGoogle Scholar