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Association between obstructive sleep apnea and optic neuropathy: a Taiwanese population-based cohort study

Eyevolume 32pages13531358 (2018) | Download Citation

Abstract

Purpose

Obstructive sleep apnea (OSA) is associated with many systemic diseases including diabetes, hypertension, stroke, and cardiovascular disease. The aim of our study was to investigate the association between OSA and optic neuropathy (ON), and to evaluate the efficacy of treatment for OSA on the risk of ON.

Methods

We used the data from the Longitudinal Health Insurance Database, which involved one million insurants from Taiwan National Health Insurance program (Taiwan NHI).

Results

OSA patients had a 1.95-fold higher risk of ON compared with non-OSA patients in all age group. The risk was significantly higher (adjusted hazard ratio: 4.21) in the group aged <45 years and male individuals (adjusted hazard ratio: 1.93). Meanwhile, sleep apnea was associated with ON regardless of the existence of comorbidity or not. OSA patients treated with continuous positive airway pressure (CPAP) had an adjusted 2.31-fold higher hazard of developing ON compared to controls, and those without any treatment had an adjusted 1.82-fold higher hazard of developing ON compared to controls. Moreover, ON patients had a 1.45-fold higher risk of OSA, and those aged between 45 and 64 years (hazard ratio: 1.76) and male individuals (hazard ratio: 1.55) had highest risk.

Conclusions

Our study showed that OSA increased the risk of developing ON after controlling the comorbidities; however, treatment with CPAP did not reduce the risk of ON. Further large population study accessing to medical records about the severity of OSA and treatment for OSA is needed to clarify the efficacy of treatment for OSA in reducing the risk of ON.

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Acknowledgements

This study was supported by Taiwan Ministry of Health and Welfare, Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019); China Medical University Hospital and Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037); NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039 -005); and Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan as well as Katsuzo and Kiyo Aoshima Memorial Funds, Japan, respectively.

Author information

Affiliations

  1. Department of Ophthalmology, Chang Gung Memorial Hospital Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan

    • Ming-Hui Sun M.D, Ph.D
  2. Department of Ophthalmology, Stanford University, Stanford, CA, USA

    • Yaping Joyce Liao M.D, Ph.D
  3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    • Che-Chen Lin M.S
  4. College of Medicine, China Medical University, Taichung, Taiwan

    • Che-Chen Lin M.S
  5. Healthcare Service Research Center (HSRC), Taichung Veterans General Hospital, Taichung, Taiwan

    • Che-Chen Lin M.S
  6. Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    • Rayleigh Ping-Ying Chiang M.D, M.M.S
  7. Department of Nursing, University of Kang Ning, Taipei, Taiwan

    • Rayleigh Ping-Ying Chiang M.D, M.M.S
  8. Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    • James Cheng-Chung Wei M.D, Ph.D
  9. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan

    • James Cheng-Chung Wei M.D, Ph.D

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to James Cheng-Chung Wei M.D, Ph.D.

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DOI

https://doi.org/10.1038/s41433-018-0088-1