Is Obstructive Sleep Apnea Associated with Progressive Glaucomatous Optic Neuropathy?

Is Obstructive Sleep Apnea Associated with Progressive Glaucomatous Optic Neuropathy?

J Glaucoma. 2017 Nov 17;:

Authors: Swaminathan SS, Bhakta AS, Shi W, Feuer WJ, Abreu AR, Chediak AD, Greenfield DS

Abstract
PURPOSE: To evaluate the relationship between obstructive sleep apnea syndrome (OSAS) and glaucoma progression, and to examine the correlation between OSAS severity and rate of visual field (VF) loss.
METHODS: Patients with concurrent diagnoses of open-angle glaucoma and OSAS between 2010-2016 were identified. Enrollment criteria consisted of glaucomatous optic neuropathy and VF loss, ≥5 reliable VFs, ≥2 years of follow-up, and polysomnography (PSG) within 12 months of final VF. PSG parameters including apnea-hypopnea index (AHI) and oxygen saturation (SpO2) were collected. Eyes were classified as "progressors" or "non-progressors" based upon event analysis using Glaucoma Progression Analysis™ criteria. Two-tailed t-test comparisons were performed, and correlations between rates of VF loss and PSG parameters were assessed.
RESULTS: A total of 141 patients with OSAS and glaucoma were identified. Twenty-five patients (age 67.9±7.6 y) with OSAS (8 mild, 8 moderate, 9 severe) were enrolled. Eleven eyes (44%) were classified as progressors, and had more severe baseline VF loss (P=0.03). Progressors and non-progressors had non-significantly different (P>0.05) age (69.9±8.7 vs. 66.4±6.6 y), follow-up (4.4±0.7 vs. 4.3±1.0 y), intraocular pressure (13.1±2.8 vs. 14.9±2.5 mmHg), mean ocular perfusion pressure (49.7±5.5 vs. 48.8±9.0 mmHg), AHI (31.3±18.6 vs. 26.4±24.0), body-mass index (27.8±5.5 vs. 28.8±5.6), and SpO2 (94.1±1.6% vs. 94.0±1.6%). AHI was not correlated with slopes of VF mean deviation (r=-0.271, P=0.190) or pattern standard deviation (r=0.211, P=0.312), and no substantial increase in risk of progression was found with increase in AHI.
CONCLUSIONS: This study does not support a relationship between OSAS and glaucomatous progression. No correlation was observed between OSAS severity and rate of VF loss.

PMID: 29189544 [PubMed - as supplied by publisher]

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