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Study confirms frequent underdiagnosis of floppy eyelid syndrome in sleep apnea patients
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ORLANDO, Fla. — Historically, the incidence of floppy eyelid syndrome in patients with obstructive sleep apnea has been shown to be between 20% and 40%. A recent data mining study at a medical center found that the condition was diagnosed in only 4.37% of these patients.
Charles S. Bouchard, MD, of Loyola University Chicago, reported in a poster here at the Association for Research in Vision and Ophthalmology meeting that floppy eyelid syndrome (FES) is associated with keratoconus, obesity, obstructive sleep apnea-hypopnea syndrome (OSAHS), chronic papillary conjunctivitis and male gender.
While the pathophysiology of floppy eyelid syndrome is unknown, studies have shown an increase in matrix metalloproteinases, a decrease in elastic fibers and nonspecific signs of chronic inflammation, the authors stated in their poster.
The researchers used ICD-9 codes for ocular and systemic diseases to search the electronic database of 562,585 patients seen at Loyola University Medical Center over a 5-year period. They sought to determine the extent to which obstructive sleep apnea-hypopnea syndrome was associated with other ocular surface disease, “as this may serve to mask a true diagnosis of FES,” they said in the poster.
They also sought to determine the strongest associations among various systemic diagnoses and obstructive sleep apnea-hypopnea syndrome.
Bouchard and colleagues found that 609 patients had diagnoses of other disorders of the eyelid and that 445 had diagnoses of unspecific inflammation of the eyelid, the poster stated.
They concluded that the strongest association between obstructive sleep apnea-hypopnea syndrome and systemic disease was obesity and that the strongest ocular disease association was with floppy eyelid syndrome.
“Although the association between FES and OSAHS was significant, our data suggest it is underdiagnosed at this tertiary care medical center when compared to control values in the literature,” they said.
Disclosures: Bouchard and colleagues have no relevant financial disclosures. The study was supported by the Richard A. Perritt Charitable Foundation.