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      Primary Open-Angle Glaucoma Is Associated with Sleep Apnea Syndrome

      , , , , ,
      Ophthalmologica
      S. Karger AG

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          Abstract

          Introduction: The etiology of primary open-angle glaucoma remains unclear. Various risk factors, including vascular abnormalities, have been associated with this disease. Sleep-associated diseases, like sleep apnea syndrome, might also represent a risk factor. Sleep apnea syndrome is characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of cardiovascular and neurological sequelae. In this study, we determined the prevalence of sleep apnea syndrome in primary open-angle glaucoma patients. Methods: Overnight transcutaneous finger oximetry was performed in 30 consecutive patients having primary open-angle glaucoma. We assessed the oximetry disturbance index during night sleep, a parameter used to diagnose sleep apnea syndrome and to grade its severity. Results: Sleep apnea syndrome was more prevalent among primary open-angle glaucoma patients compared to normal historic controls of the same age and sex distribution (χ<sup>2</sup> = 9.35, d.f. = 3, p < 0.025). The oximetry disturbance index grade was significantly larger in the primary open-angle glaucoma group compared to normal controls (U = 3,352, p = 0.01). According to the oximetry disturbance index, 20% (6/30) of primary open-angle glaucoma patients had sleep apnea syndrome. Conclusion: Primary open-angle glaucoma is associated with sleep apnea syndrome. Early recognition and treatment of sleep apnea syndrome are important to avoid cardiovascular and neurological complications.

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          Most cited references2

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          High prevalence of glaucoma in patients with sleep apnea syndrome.

          To determine the prevalence of glaucoma in sleep apnea syndrome (SAS), an entity characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of cardiovascular and neurologic sequelae. Cross-sectional study. A total of 114 white patients consecutively referred for polysomnographic evaluation of suspected SAS. Complete ophthalmologic examination, including computerized perimetry and simultaneous stereoscopic optic disc photographs. Spearman rank correlations between the respiratory disturbance index during night sleep (RDI), a value used to diagnose and grade SAS, and visual acuity, intraocular pressure (IOP), visual field indices, presence or absence of glaucomatous optic disc changes, and diagnosis of glaucoma. Each correlation was controlled for age and body mass index. To compare proportions of patients harboring glaucoma, the binomial test was used. Sixty-nine (60.5%) of the 114 patients had an RDI > or =10, which indicates SAS. Three patients had primary open-angle glaucoma, and two had normal-tension glaucoma. All patients with glaucoma had SAS. The observed prevalence of glaucoma in patients with SAS (5 of 69, 7.2%) was significantly higher than expected in a white population (2%) (P = 0.01). The RDI correlated positively with IOP (P = 0.025), visual field loss variance (P = 0.03), glaucomatous optic disc changes (P = 0.001), and diagnosis of glaucoma (P = 0.01). Patients with SAS constitute a high-risk population for glaucoma and should therefore be screened for glaucoma.
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            The endothelium and cardiovascular disease--a complex relation.

            T Lüscher (1994)
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              Author and article information

              Journal
              Ophthalmologica
              Ophthalmologica
              S. Karger AG
              0030-3755
              1423-0267
              April 1 2000
              2000
              March 15 2000
              : 214
              : 2
              : 115-118
              Article
              10.1159/000027478
              12acd5b6-7ac3-4234-9bf4-5517a683772b
              © 2000

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              https://www.karger.com/Services/SiteLicenses

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