Arthur H Friedlander1, Lindsay L Graves2, Tina I Chang3, K Karl Kawakami3, Urie K Lee2, Shannon C Grabich4, Zhuang T Fang5, Michelle R Zeidler6, JoAnn A Giaconi7. 1. VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, CA, USA; Hospital Dental Service, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA. Electronic address: Arthur.Friedlander@va.gov. 2. VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 3. VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, CA, USA. 4. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 5. Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA and the Ronald Reagan UCLA Medical Center Los Angeles, CA, USA; Stein Operating Room, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA. 6. Sleep Disorders Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Medicine-Pulmonary Critical Care, David Geffen School of Medicine at UCLA and the Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA; UCLA Sleep Fellowship: Division of Pulmonary, Critical Care and Sleep Medicine, David Geffen School of Medicine at UCLA and the Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA. 7. VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Stein Eye Institute, David Geffen School of Medicine at UCLA and the Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Abstract
OBJECTIVE: Our objective was to determine primary open-angle glaucoma (POAG) prevalence among obstructive sleep apnea (OSA) patients because the perioperative environment risks further damaging the optic nerve. STUDY DESIGN: We analyzed a "convenience sample" referred by Sleep Medicine for oral appliances because of continuous positive airway pressure intolerance. We determined the aggregate prevalence of the 3 POAG subtypes-"classic" open-angle glaucoma (COAG), normal-tension glaucoma (NTG), and open-angle glaucoma suspect (OAGS)-among the index population and compared it with that of same hospital's general population. Similarly determined were associations between OSA severity levels (apnea-hypopnea index [AHI]) and POAG subtypes. RESULTS: Among the study sample of 225 patients with OSA (96.4% male; mean age 58.5 ± 12.3 years), 47 (20.9%) had POAG, with a subtype distribution of COAG: 12 (25.5%), NTG: 8 (17.0%), and OAGS: 27 (57.4%). The POAG prevalence rate among medical center's general population was 2.5%, which was significantly less (P < .00001) than among those with comorbid OSA. Severity of the breathing disorder (AHI) failed to identify a significant correlation to any POAG subtype (P > .05). CONCLUSION: The significant prevalence of POAG among OSA sufferers suggests need for preoperative consultations from an ophthalmologist to determine eye health and possibly an anesthesiologist to avoid potential vision loss. Published by Elsevier Inc.
OBJECTIVE: Our objective was to determine primary open-angle glaucoma (POAG) prevalence among obstructive sleep apnea (OSA) patients because the perioperative environment risks further damaging the optic nerve. STUDY DESIGN: We analyzed a "convenience sample" referred by Sleep Medicine for oral appliances because of continuous positive airway pressure intolerance. We determined the aggregate prevalence of the 3 POAG subtypes-"classic" open-angle glaucoma (COAG), normal-tension glaucoma (NTG), and open-angle glaucoma suspect (OAGS)-among the index population and compared it with that of same hospital's general population. Similarly determined were associations between OSA severity levels (apnea-hypopnea index [AHI]) and POAG subtypes. RESULTS: Among the study sample of 225 patients with OSA (96.4% male; mean age 58.5 ± 12.3 years), 47 (20.9%) had POAG, with a subtype distribution of COAG: 12 (25.5%), NTG: 8 (17.0%), and OAGS: 27 (57.4%). The POAG prevalence rate among medical center's general population was 2.5%, which was significantly less (P < .00001) than among those with comorbid OSA. Severity of the breathing disorder (AHI) failed to identify a significant correlation to any POAG subtype (P > .05). CONCLUSION: The significant prevalence of POAG among OSA sufferers suggests need for preoperative consultations from an ophthalmologist to determine eye health and possibly an anesthesiologist to avoid potential vision loss. Published by Elsevier Inc.
Authors: Rana Torabi; Alon Harris; Brent Siesky; Ryan Zukerman; Francesco Oddone; Sunu Mathew; Ingrida Januleviciene; Alice C Verticchio Vercellin Journal: J Ophthalmic Vis Res Date: 2021-10-25