Severe sleep apnea associated with DME

SAN FRANCISCO — Severe obstructive sleep apnea may be associated with more severe diabetic macular edema, leading to refractory DME, according to a speaker here.
“In a JAMA study in 2017, [the authors found] when hypoxia occurs, it will directly increase the secretion of VEGF from retinal pigment epithelial cells. Based on this, we suspected there might be some relation between [obstructive sleep apnea] and DME,” Jui-Fan Chiang, MD, said at the American Academy of Ophthalmology annual meeting.
A retrospective study of patients at Chang Gung Memorial Hospital in Taiwan evaluated 97 eyes of 51 patients who underwent both polysomnography and OCT. There were 66 non-DME eyes and 31 DME eyes.
“We found that DME was significantly associated with higher [Apnea-Hypopnea Index] and more severe [obstructive sleep apnea],” Chiang said.
The rate of severe obstructive sleep apnea, defined as 30 or more apnea/hypopnea events, was 80.6% in patients with DME compared with 45.5% in those who did not have DME. In addition, the more severe the sleep apnea was, the more severe DME was.
The study was limited by its small sample size and retrospective nature, but its findings warrant a larger study of the correlation, Chiang said. – by Rebecca L. Forand
Reference:
Chiang J, et al. Association between obstructive sleep apnea and DME in patients with type 2 diabetes. Presented at: American Academy of Ophthalmology annual meeting; Oct. 11-15, 2019; San Francisco.
Disclosure: Chiang reports no relevant financial disclosures.