Higher risk for obstructive sleep apnea linked to glaucoma in Malay adults in Singapore
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Intermediate or high risk for obstructive sleep apnea was associated with a 50% greater chance of having glaucoma in a population of Singaporean adults, with researchers reporting a twofold greater risk for glaucoma in Malay individuals.
“Screening for glaucoma in [obstructive sleep apnea (OSA)] populations may be warranted to aid [eye care providers] and sleep physicians to better understand the OSA-glaucoma relationship, so that relevant ocular disorders such as glaucoma can be recognized, diagnosed and treated early,” Anjali Mehta, BS, of the Singapore Eye Research Institute, and colleagues wrote in the Journal of Glaucoma. “Longitudinal studies are needed to explore the impact of objectively assessed OSA on glaucoma and its subtypes.”
In the population-based, cross-sectional Singapore Epidemiology of Eye Diseases study, researchers collected data from 3,126 participants of Indian and Malay ethnicity, aged 40 years or older, between 2011 and 2015. They classified individuals into groups by primary closed-angle glaucoma (PCAG) and primary open-angle glaucoma (POAG).
Researchers assessed risk for OSA with the Snoring, Tiredness, Observed apnea, High blood pressure, Body mass index, Age, Neck circumference and male Gender (STOP-Bang,) questionnaire and categorized participants as low risk or intermediate/high risk.
According to analysis, 1,182 participants had an intermediate or high risk of OSA, and 134 had glaucoma, 86 had POAG, 22 had PACG, and 26 had secondary glaucomas. Researchers reported that individuals with intermediate or high risk for OSA had a 50% greater chance of having glaucoma compared with those with a low risk for OSA (P = .035).
Further, they observed a nonsignificant increase in POAG likelihood in those with intermediate or high risk for OSA compared with those with low risk. While Malays with intermediate or higher risk for OSA had a twofold risk for having any kind of glaucoma (P = .019), the same risk was not reported for participants of Indian ethnicity.
“Against the backdrop of several methodological limitations, we found that intermediate or high risk of OSA may be associated with 50% higher odds of having glaucoma in adults living in Singapore, with this association apparently driven by Malay ethnicity, although additional sleep studies to confirm this finding are needed,” Mehta and colleagues concluded.
Perspective
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Glaucoma is a group of eye conditions that involves progressive degeneration of the optic nerve. Left untreated, glaucoma can lead to irreversible vision loss and can negatively impact patient quality of life. Therefore, it is imperative that it is detected early and that the risk factors are well understood.
One of the risk factors includes OSA, which is a sleep-related breathing disorder characterized by episodes of complete or partial collapse of the airway leading to decreased oxygen saturation.
Many studies have explored the association between glaucoma and OSA, some of which have claimed that OSA is a potential risk factor for developing glaucoma or vice versa. This study highlights the relationship between these two conditions and may even lower our threshold to initiate treatment in patients with glaucoma and OSA. Moreover, the study affirms the importance for eye care providers to take an interdisciplinary approach when managing patients with glaucoma. Lastly, early detection is critical for the prevention of disease progression as well as the preservation of visual function.
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