Associations between Optic Disc Measures and Obstructive Sleep Apnea in Young Adults

Samantha S. Y. Lee; Nigel McArdle; Paul G. Sanfilippo; Seyhan Yazar; Peter R. Eastwood; Alex W. Hewitt; Qiang Li; David A. Mackey

doi:10.1016/j.ophtha.2019.04.041

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Associations between Optic Disc Measures and Obstructive Sleep Apnea in Young Adults

Journal article

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Associations between Optic Disc Measures and Obstructive Sleep Apnea in Young Adults

Samantha S. Y. Lee, Nigel McArdle, Paul G. Sanfilippo, Seyhan Yazar, Peter R. Eastwood, Alex W. Hewitt, Qiang Li and David A. Mackey

Ophthalmology (Rochester, Minn.), Vol.126(10), pp.1372-1384

2019

DOI: https://doi.org/10.1016/j.ophtha.2019.04.041

PMID: 31196726

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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.

Details

Title: Associations between Optic Disc Measures and Obstructive Sleep Apnea in Young Adults
Authors/Creators: Samantha S. Y. Lee - Lions Eye Institute
Nigel McArdle - Sir Charles Gairdner Hospital
Paul G. Sanfilippo - Lions Eye Institute
Seyhan Yazar - Lions Eye Institute
Peter R. Eastwood - The University of Western Australia
Alex W. Hewitt - Lions Eye Institute
Qiang Li - Lions Eye Institute
David A. Mackey - Lions Eye Institute
Publication Details: Ophthalmology (Rochester, Minn.), Vol.126(10), pp.1372-1384
Publisher: Elsevier
Number of pages: 13
Grant note: University of Western Australia, Perth, Western Australia, Australia Victorian Government Ophthalmic Research Institute of Australia (Surry Hills, New South Wales, Australia) University of Notre Dame (Frementle, Australia) Women's and Infant's Research Foundation (Subiaco, Western Australia, Australia) Edith Cowan University (Joondalup, Western Australia, Australia) Australian National Health and Medical Research Council; National Health and Medical Research Council (NHMRC) of Australia Telethon Institute for Child Health Research (Nedlands, Western Australia, Australia) Raine Medical Research Foundation (Nedlands, Western Australia, Australia) University of Western Australia Faculty of Medicine, Dentistry and Health Sciences, Perth, Western Australia, Australia Australian Foundation for the Prevention of Blindness (Nedlands, Western Australia, Australia) Curtin University (Perth, Western Australia, Australia) 1021105 / National Health and Medical Research Council (Canberra, Australian Capital Territory, Australia); National Health and Medical Research Council (NHMRC) of Australia BrightFocus Foundation (Clarksburg, Maryland); BrightFocus Foundation Murdoch University (Perth, Western Australia, Australia)
Identifiers: 991005592653107891
Copyright: © 2019 by the American Academy of Ophthalmology
Murdoch Affiliation: Vice Chancellery
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.137 Sleep Science & Circadian Systems; 1.137.382 Obstructive Sleep Apnea
Web Of Science research areas: Ophthalmology
ESI research areas: Clinical Medicine