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

Sleep Breath. 2016 Dec;20(4):1145-1154. doi: 10.1007/s11325-016-1358-4. Epub 2016 May 26.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Central serous chorioretinopathy; Floppy eyelids; Glaucoma; Nonarteritic anterior ischemic optic neuropathy; Obstructive sleep apnea.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Blepharoptosis / diagnosis
  • Blepharoptosis / epidemiology
  • Central Serous Chorioretinopathy / diagnosis
  • Central Serous Chorioretinopathy / epidemiology
  • Cross-Sectional Studies
  • Eye Diseases / diagnosis*
  • Eye Diseases / epidemiology*
  • Glaucoma / diagnosis
  • Glaucoma / epidemiology
  • Humans
  • Odds Ratio
  • Optic Neuropathy, Ischemic / diagnosis
  • Optic Neuropathy, Ischemic / epidemiology
  • Retinal Vein Occlusion / diagnosis
  • Retinal Vein Occlusion / epidemiology
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*
  • Statistics as Topic