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Corneal hysteresis lower in moderate/severe obstructive sleep apnea
Researchers may have discovered another link between obstructive sleep apnea syndrome and the development of glaucoma, with a cross-sectional observational study on corneal hysteresis.
Patients underwent overnight polysomnography for assessment of obstructive sleep apnea syndrome (OSAS).
Researchers measured central corneal thickness using biometry, corneal hysteresis using ocular response analysis, IOP and Humphrey visual field.
Patients were divided into normal, mild, moderate and severe OSAS categories.
A total of 56 patients were classified as normal and mild categories and placed into group 1, and 61 patients were moderate and severe and made up group 2.
Corneal hysteresis was lower in group 2, according to researchers. They found a significant difference in corneal hysteresis between the OSAS groups.
One reason for the change may involve a coupled connective tissue and vascular abnormality associated with floppy eyelid syndrome, which is linked to OSAS, the researchers proposed.
Another reason could be reduced rapid eye movement sleep.
Researchers did not find statistically significant differences in central corneal thickness or visual indices between the groups.
Researchers conclude that it may be helpful to monitor patients with more severe OSAS for the development of glaucoma. – by Abigail Sutton
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Corneal hysteresis has become a relevant biometric factor in assessing glaucoma pathogenesis, with possible insights into likelihood for disease development and rate of progression. Admittedly, I do not have the technology for obtaining this measurement in my glaucoma practice. However, its utility as a diagnostic or predictive tool would be similar to knowing central corneal thickness.
Never does it tell us a person does or doesn’t have glaucoma. It may nudge a clinician to be more aggressive with ocular hypotensive treatments or increase the frequency of testing to identify progression earlier in those who you might predict a worse course of the disease.
For those clinicians who do not measure corneal hysteresis, like myself, this study simply tells us that patients with obstructive sleep apnea (OSA) who do not currently have glaucoma should be watched closely for conversion to glaucoma. So maybe instead of a routine annual eye exam for these patients, I might add in annual retinal nerve fiber layer and ganglion cell layer optical coherence tomography measurements to complement my optic nerve evaluation, looking for the earliest signs of the disease in patients with severe OSA.