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Data suggest link between sleep apnea, normal-tension glaucoma

J Glaucoma. 2011;20(9):553-558.

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Normal-tension glaucoma was more prevalent in patients with obstructive sleep apnea/hypopnea syndrome than in patients without the disorder, a study found.

"The severity of obstructive sleep apnea/hypopnea syndrome inversely correlated with retinal nerve fiber layer thickness," the study authors said. "Clinicians need to consider the possibility of glaucoma in patients with moderate and severe obstructive sleep apnea/hypopnea syndrome."

The study included 247 patients with symptoms of sleep apnea who underwent overnight polysomnography; 209 patients were diagnosed with obstructive sleep apnea/hypopnea syndrome (OSAHS) and 38 patients were classified as normal.

All patients underwent evaluation of best corrected visual acuity, IOP, central corneal thickness, gonioscopy, funduscopy, automated visual field testing and retinal nerve fiber layer status.

One patient had mild OSAHS, three patients had moderate OSAHS and eight patients had severe OSAHS.

Study results showed that normal-tension glaucoma was identified in 12 patients with OSAHS (5.7%). The prevalence of normal-tension glaucoma was significantly higher in the OSAHS group than in the non-glaucoma group (P = .003).

Normal-tension glaucoma was significantly more prevalent in patients with moderate or severe OSAHS than in normal patients or those with mild OSAHS (P = .033).

In patients with moderate or severe OSAHS, significantly reduced retinal nerve fiber layer thickness was observed in the superior quadrant (P = .032) and temporal quadrant (P = .021), the authors said.