Although researchers recently confirmed a high prevalence of obstructive sleep apnea (OSA) among patients with primary open-angle glaucoma (POAG), they also note that its prevalence was not higher than in people without glaucoma matched for known OSA risk factors. Researchers have long suspected that OSA may play a role in POAG development and progression, given plausible pathophysiological mechanisms and limited epidemiological data, the researchers admit. However, their new findings bring that into question.
The single-center study evaluated 235 POAG patients and 160 healthy controls who underwent comprehensive ocular assessments and nocturnal multichannel cardiorespiratory monitoring.
The team found 58% of POAG patients had OSA, compared with 54% of healthy controls—no statistically significant difference. Of those with OSA, 22% of POAG patients and 16% of healthy controls had moderate or severe OSA. They also found no difference in several markers of nocturnal hypoxia and both groups reported a similar level of subjective sleepiness. The data suggests routine screening of POAG patients for OSA would yield similar results as screening the general population. The high rate of OSA in both groups is likely due to the increased rate of OSA in an older population, the researchers admit.
Lastly, the found no association between OSA severity markers and indicators of optic nerve structure and function such as retinal nerve fiber later thinning.
Although screening for OSA among patients with POAG is part of glaucoma workup recommendations, the researchers feel their new data does not support such practice.
|Wozniak D, Bourne R, Peretz G, et al. Obstructive sleep apnea in patients with primary open-angle glaucoma. J Glaucoma. May 31, 2019. [Epub ahead of print].