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REVIEW ARTICLE
Year : 2016  |  Volume : 9  |  Issue : 3  |  Page : 125-134

Glaucoma and its association with obstructive sleep apnea: A narrative review


1 Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
2 OEU Institute of Ophthalmology, Kasturba Medical College, Manipal University, Manipal, India
3 Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

Correspondence Address:
Ramesh S Ve
Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-620X.192261

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Obstructive sleep apnea (OSA) is one of the systemic risk factors for glaucoma which causes irreversible visual field (VF) damage. We reviewed the published data of all types of studies on the association between these two conditions and papers regarding functional and structural changes related to glaucomatous damage using Scopus, web of science, and PubMed databases. There is evidence that the prevalence of glaucoma is higher in OSA patients, which independent of intraocular pressure (IOP). Studies have reported thinning of retinal nerve fiber layer (RNFL), alteration of optic nerve head, choroidal and macular thickness, and reduced VF sensitivity in patients of OSA with no history glaucoma. A negative correlation of apnea-hypopnea index with RNFL and VF indices has been described in some studies. Raised IOP was noted which is possibly related to obesity, supine position during sleep, and raised intracranial pressure. Diurnal fluctuations of IOP show more variations in OSA patients before and after continuous positive airway pressure (CPAP) therapy when compared with the normal cases. The vascular factors behind the pathogenesis include recurrent hypoxia with increased vascular resistance, oxidative stress damage to the optic nerve. In conclusion, comprehensive glaucoma evaluation should be recommended in patients with OSA and should also periodically monitor IOP during CPAP treatment which may trigger the progression of glaucomatous damage.


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