Loss of intrinsically photosensitive retinal ganglion cells in glaucoma may affect sleep quality

Decreased function of intrinsically photosensitive retinal ganglion cells may affect pupillary response and sleep quality in glaucoma patients, according to a study.

The cross-sectional study evaluated both eyes of 32 glaucoma patients and 13 healthy subjects using pupillary light reflex and polysomnography to correlate intrinsically photosensitive retinal ganglion cell function and retinal nerve fiber layer (RNFL) thickness with structural damage parameters in glaucoma.

Patients with glaucoma had significantly lower mean total sleep time, sleep efficiency and minimum oxyhemoglobin saturation compared with the control group. They also had higher mean arousal durations after falling asleep and periodic limb movements associated with arousals.

For pupillary light reflex, glaucoma patients had significantly lower peak responses to the 250 cd/m² blue flash and the average rapid eye movement latency, and lower sustained responses to the 250 cd/m² blue flash and arousal parameters, both associated with a thinner mean RNFL.

For the polysomnography, a thinner mean RNFL thickness was associated with a poorer oxygen desaturation index in glaucoma patients.

“Circadian function has not been well investigated in clinical daily practice, but it can interfere with the quality of life of these patients,” the study authors said. “Concerns about sleep disturbances in patients with glaucoma should be incorporated into clinical evaluations.” – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.

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Source:

Gracitelli CPB, et al. Ophthalmology. 2015;doi:10.1016/j.ophtha.2015.02.030.