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Prospective evaluation of the comorbidity of obstructive sleep apnea in patients with glaucoma.

STUDY OBJECTIVES
This study aimed to prospectively identify the correlation between obstructive sleep apnea (OSA) severity, ocular microcirculation changes, and visual function changes in patients with glaucoma.


METHODS
We prospectively enrolled patients with glaucoma who were willing to undergo overnight polysomnography (PSG). The enrolled patients were further divided into normal tension glaucoma (NTG),high-tension glaucoma (HTG), and control. Visual field (VF) progression was analyzed using sequential standard automated perimetry. Peripapillary and macular vessel density (VD) were assessed through optical coherence tomography angiography (OCT-Angiography). The associations between PSG parameters, OCT-Angiography parameters, and VF progression were analyzed.


RESULTS
A total of 22 patients with NTG, 30 patients with HTG, and 24 control patients were enrolled. Through regression analysis, glaucoma was found to be an independent predictor of moderate-to-severe OSA (P = .035); furthermore, moderate-to-severe OSA was significantly associated with VF progression (P =.008 in the HTG subgroup, and P = .008 in the overall glaucoma). Additionally, OSA severity was negatively correlated with the ganglion cell complex thinning rate in the NTG subgroup.


CONCLUSIONS
Presence of glaucoma increased the risk of moderate-to-severe OSA compare with the control group. OSA severity was related to VF deterioration in patients with glaucoma and further associated with structural progression in the NTG subgroup. Careful monitoring of the comorbid OSA status of patients with glaucoma is essential to prevent disease progression.