Prevalence of Primary Open-Angle Glaucoma in Patients with Obstructive Sleep Apnea Syndrome in Thailand

Objective : To determine the prevalence of primary open-angle glaucoma (POAG) among patients with obstructive sleep apnea syndrome and to identify factors associated with intraocular pressure (IOP). Materials and Methods : Eighty-eight patients with obstructive sleep apnea (OSA) and 88 control subjects were enrolled. All subjects underwent eye examination including visual acuity, IOP, gonioscopy, optic disc, and visual field evaluation within one week of enrollment. Results : Three of the 88 patients with OSA (3.4%) and only one (1.1%) in the matched group had POAG, indicating no statistically significant difference in both groups (p=0.621). All patients with OSA diagnosed with POAG had severe OSA. OSA did not significantly influence the risk factor of POAG (OR 3.07, 95% CI 0.31 to 30.11, p=0.312). However, the presence of mean oxygen saturation of less than 88% or oxygen desaturation index (ODI) greater than 30 events per hour correlated with an elevation of IOP (p=0.026, 0.010). Based on apnea-hypopnea index (AHI) and ODI, there was medium correlation with IOP (Pearson correlation 0.342, 95% CI 0.143 to 0.5147, p=0.0011 and Pearson correlation 0.317, 95% CI 0.116 to 0.494, p=0.0025). Conclusion : The prevalence of POAG was 3.4% in patients with OSA when compared with 1.1% in control group. There was positive correlation between AHI or ODI with the IOP. Moreover, the presence of mean oxygen saturation of less than 88% or ODI of more than 30 events per hour correlated with an elevated IOP. Keywords : Glaucoma, Obstructive sleep apnea, Prevalence, Primary open-angle glaucoma, Sleep apnea DOI : doi.org/10.35755/jmedassocthai.2021.05.12109 Received 14 October 2020 | Revised 4 February 2021 | Accepted 15 February 2021