Samantha S Y Lee1, Nigel McArdle2, Paul G Sanfilippo3, Seyhan Yazar4, Peter R Eastwood2, Alex W Hewitt5, Qiang Li1, David A Mackey6. 1. Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia. 2. Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, Australia; West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, Australia. 3. Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia; Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia. 4. Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia; MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom. 5. Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia; Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia. 6. Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia; Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia. Electronic address: d.mackey@utas.edu.au.
Abstract
PURPOSE: Obstructive sleep apnea (OSA) is linked to increased glaucoma risk in middle-aged and older adults. However, little is known about associations between OSA and glaucoma-related optic disc parameters in young adults. We explored associations between overnight polysomnography-derived measures of OSA and the optic disc in young adults. DESIGN: Cross-sectional cohort study. PARTICIPANTS: Eight hundred forty-eight adults 19 to 22 years of age. METHODS: Participants underwent an ophthalmic examination that included OCT imaging of the optic disc and measurements of intraocular pressure, axial length, and refractive error. Participants then underwent an overnight polysomnography study that obtained measurements of apnea-hypopnea index (AHI), peripheral oxygen saturation level, and number of cortical arousals from sleep. Based on the AHI results, participants were grouped into no OSA (AHI < 5 events/hour), mild OSA (AHI ≥ 5 and <15 events/hour), moderate OSA (AHI ≥ 15 and <30 events/hour), or severe OSA (AHI ≥ 30 events/hour). MAIN OUTCOME MEASURES: Neuroretinal rim area, horizontal and vertical widths, and peripapillary retinal nerve fiber layer (RNFL) thickness. RESULTS: The median AHI result across the study cohort was 2.2 events per hour (interquartile range, 1.0-4.4 events/hour). Based on the AHI results, 178 participants (21.0%) demonstrated OSA: 150 with mild OSA, 26 with moderate OSA, and 2 with severe OSA. In the unadjusted analyses, participants with OSA on average showed thinner peripapillary RNFL at the inferotemporal (P = 0.026) and superotemporal (P = 0.008) segments compared with those without OSA. Additionally, higher AHI results were associated with thinner RNFL superotemporally (P = 0.007). These findings remained significant after adjusting for gender, body mass index, ethnicity, and potential ocular confounders. There were no significant differences in optic disc measures between groups of OSA severity. CONCLUSIONS: Obstructive sleep apnea may be associated with preclinical thinning of the peripapillary RNFL in young adults. This suggests that an increased glaucoma risk already may be present in individuals with OSA since young adulthood. Long-term follow-up of this cohort will allow further optic disc changes in relationship to polysomnography parameters to be documented and associations with future glaucoma diagnosis to be explored.
PURPOSE: Obstructive sleep apnea (OSA) is linked to increased glaucoma risk in middle-aged and older adults. However, little is known about associations between OSA and glaucoma-related optic disc parameters in young adults. We explored associations between overnight polysomnography-derived measures of OSA and the optic disc in young adults. DESIGN: Cross-sectional cohort study. PARTICIPANTS: Eight hundred forty-eight adults 19 to 22 years of age. METHODS:Participants underwent an ophthalmic examination that included OCT imaging of the optic disc and measurements of intraocular pressure, axial length, and refractive error. Participants then underwent an overnight polysomnography study that obtained measurements of apnea-hypopnea index (AHI), peripheral oxygen saturation level, and number of cortical arousals from sleep. Based on the AHI results, participants were grouped into no OSA (AHI < 5 events/hour), mild OSA (AHI ≥ 5 and <15 events/hour), moderate OSA (AHI ≥ 15 and <30 events/hour), or severe OSA (AHI ≥ 30 events/hour). MAIN OUTCOME MEASURES: Neuroretinal rim area, horizontal and vertical widths, and peripapillary retinal nerve fiber layer (RNFL) thickness. RESULTS: The median AHI result across the study cohort was 2.2 events per hour (interquartile range, 1.0-4.4 events/hour). Based on the AHI results, 178 participants (21.0%) demonstrated OSA: 150 with mild OSA, 26 with moderate OSA, and 2 with severe OSA. In the unadjusted analyses, participants with OSA on average showed thinner peripapillary RNFL at the inferotemporal (P = 0.026) and superotemporal (P = 0.008) segments compared with those without OSA. Additionally, higher AHI results were associated with thinner RNFL superotemporally (P = 0.007). These findings remained significant after adjusting for gender, body mass index, ethnicity, and potential ocular confounders. There were no significant differences in optic disc measures between groups of OSA severity. CONCLUSIONS: Obstructive sleep apnea may be associated with preclinical thinning of the peripapillary RNFL in young adults. This suggests that an increased glaucoma risk already may be present in individuals with OSA since young adulthood. Long-term follow-up of this cohort will allow further optic disc changes in relationship to polysomnography parameters to be documented and associations with future glaucoma diagnosis to be explored.
Authors: Xikun Han; Samantha Sze-Yee Lee; Stuart MacGregor; David A Mackey; Nathan Ingold; Nigel McArdle; Anthony P Khawaja Journal: BMC Med Date: 2021-05-11 Impact factor: 11.150
Authors: Samantha Sze-Yee Lee; Darren John Beales; Fred K Chen; Seyhan Yazar; David Alonso-Caneiro; David A Mackey Journal: Sci Rep Date: 2021-03-17 Impact factor: 4.379
Authors: Samantha Sze-Yee Lee; Gareth Lingham; Seyhan Yazar; Paul G Sanfilippo; Jason Charng; Fred K Chen; Alex W Hewitt; Fletcher Ng; Christopher Hammond; Leon M Straker; Peter R Eastwood; Stuart MacGregor; Kathryn A Rose; Robyn M Lucas; Jeremy A Guggenheim; Seang-Mei Saw; Minas T Coroneo; Mingguang He; David A Mackey Journal: BMJ Open Date: 2020-03-25 Impact factor: 2.692