Obstructive Sleep Apnoea and Glaucoma Connections: A Cross Sectional Study

Abstract

Introduction: Obstructive sleep apnoea (OSA) has been identified as a possible risk factor for glaucoma. Due to airway obstruction, there is decreased optic nerve perfusion pressure. This may lead to varied ophthalmic manifestations including glaucoma.

Aims: To find out positive co-relation between glaucoma parameters and OSA. Methods: 53 diagnosed OSA patients underwent comprehensive ophthalmic evaluation. The data was compared with an age-sex matched control.

Results: The study included 53 participants with OSA and 53 controls, with comparable mean age (52.4 ± 9.6 vs. 51.9 ± 8.8 years; p = 0.74) and male sex distribution (77.4% vs. 75.5%; p = 0.81). Among OSA participants, 34 (64.1%) had mild, 13 (24.5%) moderate, and 6 (11.4%) severe OSA (p < 0.001). Visual field defects were more frequent in OSA eyes (30 [28.3%] vs. 12 [11.3%]; p = 0.002). Mean IOP was higher in the OSA group (19.75 ± 3.53 vs. 17.2 ± 2.8 mmHg; p = 0.01), while mean RNFL thickness was lower (92.1 ± 8.89 vs. 95.6 ± 7.4 µm; p = 0.10). RNFL thinning (34.0% vs. 13.2%; p < 0.001) and diffuse NRR thinning (22.6% vs. 5.7%; p < 0.001) were significantly more common in OSA. Hypertension, dyslipidemia, and diabetes were also significantly more prevalent in OSA (52.8% vs. 28.3%, p = 0.01; 41.5% vs. 18.9%, p = 0.01; and 30.2% vs. 13.2%, p = 0.03, respectively).

Conclusion: OSA was significantly associated with raised IOP, structural optic nerve abnormalities, and visual field defects, suggesting increased ocular vulnerability among affected individuals. The higher prevalence of hypertension, dyslipidemia, and diabetes further highlights the systemic burden accompanying OSA. Routine ophthalmic assessment, including IOP measurement, RNFL evaluation, optic nerve examination, and visual field testing, may therefore be beneficial in patients with OSA.