Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Obstructive sleep apnoea and glaucoma: a systematic review and meta-analysis

Eye (2023)Cite this article

Subjects

Abstract

Introduction

Obstructive sleep apnoea (OSA) has been thought to be associated with glaucoma, however there are many conflicting studies on this topic. With many new studies having been published since the previous meta-analysis, we believe it is important to clarify this association. Hence, in this study we meta-analyse the recent literature regarding the association between OSA and glaucoma.

Methods

Pubmed, Embase, Scopus and Cochrane Library were searched from inception till the 28th February 2022 for observational as well as cross-sectional studies examining the association between OSA and glaucoma. Two reviewers selected studies, extracted data, graded the quality of included non-randomized studies using the Newcastle-Ottawa scale. The overall quality of evidence was assessed using GRADE. Random-effects models were used to meta-analyse the maximally covariate- adjusted associations.

Results

48 studies were included in our systematic review, with 46 suitable for meta-analysis. Total study population was 4,566,984 patients. OSA was associated with a higher risk of glaucoma (OR 3.66, 95% CI 1.70 to 7.90, I2 = 98%, p < 0.01). After adjustment for various important confounders including age, gender and patient comorbidities such as hyperlipidaemia, hypertension, cardiovascular diseases and diabetes, patients with OSA had up to 40% higher odds of glaucoma. Substantial heterogeneity was eliminated through subgroup and sensitivity analyses after consideration of glaucoma subtype, OSA severity and adjustment for confounders.

Conclusions

In this meta-analysis, OSA was associated with higher risk of glaucoma, as well as more severe ocular findings characteristic of the glaucomatous disease process. We suggest more clinical studies looking into the effects of OSA treatment on the progression of glaucoma to help clinical decision making for patients.

摘要

引言: 阻塞性睡眠呼吸暂停 (OSA) 被认为与青光眼有关, 但是关于这个问题有许多结论相反的研究。自之前meta分析以来, 已有许多新的研究发表, 我们认为研究这种关联性是很重要的。因此, 在这项研究中, 我们对最近关于OSA和青光眼之间的关系的文献进行了元分析。

方法: 在Pubmed、Embase、Scopus和Cochrane图书馆检索了从开始到2022年2月28日的观察性研究以及研究OSA和青光眼之间关系的横断面研究。两位评审员选择研究, 提取数据, 使用纽卡斯尔-渥太华量表对纳入的非随机研究的质量进行分级。使用GRADE对证据的总体质量进行评估。使用随机效应模型对最大协变量调整后的关联进行荟萃分析。

结果: 48项研究纳入系统回顾, 其中46项适合进行meta分析。总研究人群为4,566,984名患者。OSA与较高的青光眼风险有关 (OR 3.66, 95% CI 1.70至7.90, I2 = 98%, P < 0.01) 。 在调整了各种重要的混杂因素, 包括年龄、性别和患者的合并症, 如高脂血症、高血压、心血管疾病和糖尿病后, OSA患者患青光眼的几率高达40%。在考虑了青光眼亚型、OSA严重程度和调整了混杂因素后, 通过亚组和敏感性分析消除了大量的异质性。

结论: 在这项meta分析中, OSA与较高的青光眼风险以及青光眼疾病过程中特有的更严重的眼部病变相关。建议进一步开展临床研究, 观察OSA治疗对青光眼进展的影响, 以帮助针对患者的临床决策。

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Unadjusted odds ratio for the risk of glaucoma in patients with OSA.
Fig. 2: Unadjusted odds ratios for the risk of glaucoma in patients with OSA, stratified by glaucoma subtype.
Fig. 3: Adjusted odds ratios for the risk of glaucoma in patients with OSA.
Fig. 4: Adjusted hazards ratios for the risk of glaucoma in patients with OSA.
Fig. 5: Mean difference in cup-disc ratio.
Fig. 6: Mean difference in visual field MD.
Fig. 7: Mean difference in visual field PSD.
Fig. 8: Mean difference in intraocular pressure.
Fig. 9: Mean difference intraocular pressure stratified by OSA severity.
Fig. 10: Mean difference in retinal nerve fibre layer thickness.
Fig. 11: Mean difference retinal nerve fibre layer thickness, stratified by OSA severity.
Fig. 12: Mean difference retinal nerve fibre layer thickness in non-glaucomatous eyes, comparing patients with OSA against patients without OSA, stratified by OSA severity.

References

  1. Allison K, Patel D, Alabi O. Epidemiology of glaucoma: the past, present, and predictions for the future. Cureus. 2020;12:e11686.

    PubMed  PubMed Central  Google Scholar 

  2. Anderson DR. Normal-tension glaucoma (low-tension glaucoma). Indian J Ophthalmol. 2011;59:S97–101.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7:687–98.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Chaitanya A, Pai VH, Mohapatra AK, Ve RS. Glaucoma and its association with obstructive sleep apnea: a narrative review. Oman J Ophthalmol. 2016;9:125–34.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Muniesa MJ, Benitez I, Ezpeleta J, Sanchez de la Torre M, Pazos M, Milla E, et al. Effect of CPAP therapy on 24-hour intraocular pressure-related pattern from contact lens sensors in obstructive sleep apnea syndrome. Transl Vis Sci Technol. 2021;10:10.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Liu S, Lin Y, Liu X. Meta-analysis of association of obstructive sleep apnea with glaucoma. J Glaucoma. 2016;25:1–7.

    Article  PubMed  Google Scholar 

  7. Shi Y, Liu P, Guan J, Lu Y, Su K. Association between glaucoma and obstructive sleep apnea syndrome: a meta-analysis and systematic review. PLoS One. 2015;10:e0115625.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Girkin CA, McGwin G Jr., McNeal SF, Owsley C. Is there an association between pre-existing sleep apnoea and the development of glaucoma? Br J Ophthalmol. 2006;90:679–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Roberts TV, Hodge C, Graham SL, Burlutsky G, Mitchell P. Prevalence of nocturnal oxygen desaturation and self-reported sleep-disordered breathing in glaucoma. J Glaucoma. 2009;18:114–8.

    Article  PubMed  Google Scholar 

  10. Alvarez-Sala R, Garcia IT, Garcia F, Moriche J, Prados C, Diaz S, et al. Nasal CPAP during wakefulness increases intraocular pressure in glaucoma. Monaldi Arch Chest Dis. 1994;49:394–5.

    CAS  PubMed  Google Scholar 

  11. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006–12.

    Article  PubMed  Google Scholar 

  12. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5:210.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wells G, Shea B, O’Connell D, Peterson j, Welch V, Losos M, et al. The Newcastle–Ottawa Scale (NOS) for Assessing the Quality of Non-Randomized Studies in Meta-Analysis. 2000.

  14. Dikmen N, Cakmak AI, Urfalioglu S. The effect of positive airway pressure therapy on intraocular pressure and retina in severe obstructive apnea syndrome. Sleep Biol Rhythms. 2022;20:267–73.

    Article  Google Scholar 

  15. Lin P-W, Lin H-C, Friedman M, Chang H-W, Salapatas AM, Lin M-C, et al. Effects of CPAP for patients with OSA on visual sensitivity and retinal thickness. Sleep Med. 2020;67:156–63.

    Article  PubMed  Google Scholar 

  16. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.

    Article  CAS  PubMed  Google Scholar 

  17. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.

    Article  PubMed  Google Scholar 

  18. Knapp G, Hartung J. Improved tests for a random effects meta-regression with a single covariate. Stat Med. 2003;22:2693–710.

    Article  PubMed  Google Scholar 

  19. Kadyan A, Asghar J, Dowson L, Sandramouli S. Ocular findings in sleep apnoea patients using continuous positive airway pressure. Eye. 2010;24:843–50.

    Article  CAS  PubMed  Google Scholar 

  20. Chen HY, Chang YC, Lin CC, Sung FC, Chen WC. Obstructive sleep apnea patients having surgery are less associated with glaucoma. J Ophthalmol. 2014;2014:838912.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Keenan TD, Goldacre R, Goldacre MJ. Associations between obstructive sleep apnoea, primary open angle glaucoma and age-related macular degeneration: record linkage study. Br J Ophthalmol. 2017;101:155–9.

    Article  PubMed  Google Scholar 

  22. Aptel F, Chiquet C, Tamisier R, Sapene M, Martin F, Stach B, et al. Association between glaucoma and sleep apnea in a large French multicenter prospective cohort. Sleep Med. 2014;15:576–81.

    Article  PubMed  Google Scholar 

  23. Batum M, Kisabay A, Mayali H, Goktalay T, Kurt E, Selcuki D, et al. Evaluation of effects of positive airway pressure treatment on retinal fiber thickness and visual pathways using optic coherence tomography and visual evoked potentials in the patients with severe obstructive sleep apnea syndrome. Int Ophthalmol. 2020;40:2475–85.

    Article  PubMed  Google Scholar 

  24. Asker S, Timucin OB, Ursavas A, Aslanci ME, Baykara M, Erturk H, et al. Obstructive sleep apnea syndrome and blood flow to the eyes. East J Med. 2013;18:165–71.

    Google Scholar 

  25. Casas P, Ascaso FJ, Vicente E, Tejero-Garcés G, Adiego MI, Cristóbal JA. Retinal and optic nerve evaluation by optical coherence tomography in adults with obstructive sleep apnea-hypopnea syndrome (OSAHS). Graefes Arch Clin Exp Ophthalmol. 2013;251:1625–34.

    Article  PubMed  Google Scholar 

  26. Casas P, Ascaso FJ, Vicente E, Tejero-Garcés G, Adiego MI, Cristóbal JA. Visual field defects and retinal nerve fiber imaging in patients with obstructive sleep apnea syndrome and in healthy controls. BMC Ophthalmol. 2018;18:66.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Çekiç B, Selçuk ÖT, Toslak İE, Osma Ü, Eyigör H, Erol MK. Does severe obstructive sleep apnea syndrome alter retrobulbar blood flow? A color Doppler ultrasound study. J Med Ultrason. 2018;45:487–92.

    Article  Google Scholar 

  28. Lee SSY, McArdle N, Sanfilippo PG, Yazar S, Eastwood PR, Hewitt AW, et al. Associations between optic disc measures and obstructive sleep apnea in young adults. Ophthalmology. 2019;126:1372–84.

    Article  PubMed  Google Scholar 

  29. Lee SS, Sanfilippo PG, Hunter M, Yazar S, James A, Mackey DA. Optic disc measures in obstructive sleep apnea: a community-based study of middle-aged and older adults. J Glaucoma. 2020;29:337–43.

    Article  PubMed  Google Scholar 

  30. Ozge G, Dogan D, Koylu MT, Ayyildiz O, Akincioglu D, Mumcuoglu T, et al. Retina nerve fiber layer and choroidal thickness changes in obstructive sleep apnea syndrome. Postgrad Med. 2016;128:317–22.

    Article  PubMed  Google Scholar 

  31. Sagiv O, Fishelson-Arev T, Buckman G, Mathalone N, Wolfson J, Segev E, et al. Retinal nerve fibre layer thickness measurements by optical coherence tomography in patients with sleep apnoea syndrome. Clin Exp Ophthalmol. 2014;42:132–8.

    Article  PubMed  Google Scholar 

  32. Uslu H, Kanra AY, Sarac S. Structural assessment of the optic nerve in patients with obstructive sleep apnea syndrome: Case–control study. Eur J Ophthalmol. 2020;31:1741–8.

    Article  PubMed  Google Scholar 

  33. Cristescu TR, Mihălțan FD. Ocular pathology associated with obstructive sleep apnea syndrome. Rom J Ophthalmol. 2020;64:261–8.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Chambe J, Laib S, Erhardt C, Schroder C, Ruppert E, Bourcier T, et al. Prevalence of ocular disorders in patients affected with sleep apnea syndrome. Eur Sleep Res Soc. 2010;19:305.

    Google Scholar 

  35. Han X, Lee SS, Ingold N, McArdle N, Khawaja AP, MacGregor S, et al. Associations of sleep apnoea with glaucoma and age-related macular degeneration: an analysis in the United Kingdom Biobank and the Canadian longitudinal study on aging. BMC Med. 2021;19:104.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Lin CC, Hu CC, Ho JD, Chiu HW, Lin HC. Obstructive sleep apnea and increased risk of glaucoma: a population-based matched-cohort study. Ophthalmology. 2013;120:1559–64.

    Article  PubMed  Google Scholar 

  37. Friedlander AH, Graves LL, Chang TI, Kawakami KK, Lee UK, Grabich SC, et al. Prevalence of primary open-angle glaucoma among patients with obstructive sleep apnea. Oral Surg Oral Med Oral Pathol Oral Radio. 2018;126:226–30.

    Article  Google Scholar 

  38. Bagabas N, Ghazali W, Mukhtar M, AlQassas I, Merdad R, Maniyar A, et al. Prevalence of glaucoma in patients with obstructive sleep apnea. J Epidemiol Glob Health. 2019;9:198–203.

    PubMed  PubMed Central  Google Scholar 

  39. Pedrotti E, Demasi CL, Bruni E, Bosello F, Di Sarro PP, Passilongo M, et al. Prevalence and risk factors of eye diseases in adult patients with obstructive sleep apnoea: results from the SLE.E.P.Y cohort study. BMJ Open. 2017;7:e016142.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Zengin MO, Tuncer I, Karahan E. Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome: one year follow-up results. Int J Ophthalmol. 2014;7:704–8.

    PubMed  PubMed Central  Google Scholar 

  41. Karakucuk S, Goktas S, Aksu M, Erdogan N, Demirci S, Oner A, et al. Ocular blood flow in patients with obstructive sleep apnea syndrome (OSAS). Graefes Arch Clin Exp Ophthalmol. 2008;246:129–34.

    Article  PubMed  Google Scholar 

  42. Carnero E, Bragard J, Urrestarazu E, Rivas E, Polo V, Larrosa JM, et al. Continuous intraocular pressure monitoring in patients with obstructive sleep apnea syndrome using a contact lens sensor. PLoS One. 2020;15:e0229856.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Chirapapaisan N, Likitgorn T, Pleumchitchom M, Sakiyalak D, Banhiran W, Saiman M, et al. Diurnal changes in retinal nerve fiber layer thickness with obstructive sleep apnea/hypopnea syndrome. Int J Ophthalmol. 2016;9:979–83.

    PubMed  PubMed Central  Google Scholar 

  44. Ekinci M, Huseyinoglu N, Cagatay HH, Ceylan E, Keles S, Gokce G. Is there a relationship between sleep apnea and central corneal thickness? Curr Eye Res. 2013;38:1104–9.

    Article  PubMed  Google Scholar 

  45. Ferrandez B, Ferreras A, Calvo P, Abadia B, Fogagnolo P, Wang Y, et al. Retinal sensitivity is reduced in patients with obstructive sleep apnea. Invest Ophthalmol Vis Sci. 2014;55:7119–25.

    Article  PubMed  Google Scholar 

  46. Ferrandez B, Ferreras A, Calvo P, Abadia B, Marin JM, Pajarin AB. Assessment of the retinal nerve fiber layer in individuals with obstructive sleep apnea. BMC Ophthalmol. 2016;16:40.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Gharraf H, Zidan MH, ElHoffy A. Association between obstructive sleep apnea hypopnea syndrome and normal tension glaucoma. Egypt J Chest Dis Tuberculosis. 2016;65:239–49.

    Article  Google Scholar 

  48. Gutierrez-Diaz E, Perez-Rico C, de Atauri MJ, Mencia-Gutierrez E, Blanco R. Evaluation of the visual function in obstructive sleep apnea syndrome patients and normal-tension glaucoma by means of the multifocal visual evoked potentials. Graefes Arch Clin Exp Ophthalmol. 2012;250:1681–8.

    Article  PubMed  Google Scholar 

  49. Huseyinoglu N, Ekinci M, Ozben S, Buyukuysal C, Kale MY, Sanivar HS. Optic disc and retinal nerve fiber layer parameters as indicators of neurodegenerative brain changes in patients with obstructive sleep apnea syndrome. Sleep Breath. 2014;18:95–102.

    Article  PubMed  Google Scholar 

  50. Küçük B, Sırakaya E, Delibaş Ş. Posterior segment assessment in patients with obstructive sleep apnea syndrome. Sleep Breath. 2019;23:997–1005.

    Article  PubMed  Google Scholar 

  51. Lin PW, Friedman M, Lin HC, Chang HW, Pulver TM, Chin CH. Decreased retinal nerve fiber layer thickness in patients with obstructive sleep apnea/hypopnea syndrome. Graefes Arch Clin Exp Ophthalmol. 2011;249:585–93.

    Article  PubMed  Google Scholar 

  52. Lin PW, Friedman M, Lin HC, Chang HW, Wilson M, Lin MC. Normal tension glaucoma in patients with obstructive sleep apnea/hypopnea syndrome. J Glaucoma. 2011;20:553–8.

    Article  PubMed  Google Scholar 

  53. Moghimi S, Ahmadraji A, Sotoodeh H, Sadeghniat K, Maghsoudipour M, Fakhraie G, et al. Retinal nerve fiber thickness is reduced in sleep apnea syndrome. Sleep Med. 2013;14:53–7.

    Article  PubMed  Google Scholar 

  54. Mojon DS, Hess CW, Goldblum D, Fleischhauer J, Koerner F, Bassetti C, et al. High prevalence of glaucoma in patients with sleep apnea syndrome. Ophthalmology. 1999;106:1009–12.

    Article  CAS  PubMed  Google Scholar 

  55. Morsy NE, Amani BE, Magda AA, Nabil AJ, Pandi-Perumal SR, BaHammam AS, et al. Prevalence and predictors of ocular complications in obstructive sleep apnea patients: a cross-sectional case-control study. Open Respir Med J. 2019;13:19–30.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Ngoo QZ, A NF, A B, Wh WH. Evaluation of retinal nerve fiber layer thickness and optic nerve head parameters in obstructive sleep apnoea patients. Korean J Ophthalmol. 2021;35:223–30.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Zengin MO, Öztura I, Arikan G, Günenç Ü, Parlak M, Ergin MH. The relationship between obstructive sleep apnea syndrome and glaucoma. Turkiye Klinikleri Tip Bilimleri Derg. 2012;32:990–6.

    Google Scholar 

  58. Gürsel Özkurt Z, Demir M, Yıldırım Y, Balsak S, Karaalp Ü. Evaluation of subclinical papilledema in patients with obstructive sleep apnea syndrome. East J Med. 2019;24:74–9.

    Article  Google Scholar 

  59. Salzgeber R, Iliev ME, Mathis J. Do optic nerve head and visual field parameters in patients with obstructive sleep apnea syndrome differ from those in control individuals? Klin Monbl Augenheilkd. 2014;231:340–3.

    Article  CAS  PubMed  Google Scholar 

  60. Sergi M, Salerno DE, Rizzi M, Blini M, Andreoli A, Messenio D, et al. Prevalence of normal tension glaucoma in obstructive sleep apnea syndrome patients. J Glaucoma. 2007;16:42–6.

    Article  PubMed  Google Scholar 

  61. Ucak T, Unver E. Alterations in parafoveal and optic disc vessel densities in patients with obstructive sleep apnea syndrome. J Ophthalmol. 2020;2020:4034382.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Xin C, Zhang W, Wang L, Yang D, Wang J. Changes of visual field and optic nerve fiber layer in patients with OSAS. Sleep Breath. 2015;19:129–34.

    Article  PubMed  Google Scholar 

  63. Yazgan S, Erboy F, Celik HU, Ornek T, Ugurbas SH, Kokturk F, et al. Peripapillary choroidal thickness and retinal nerve fiber layer in untreated patients with obstructive sleep apnea-hypopnea syndrome: a case–control study. Curr Eye Res. 2017;42:1552–60.

    Article  PubMed  Google Scholar 

  64. Doyle CK, Zamba GJ, Johnson CA, Wall M. The repeatability of mean deviation with size III and size V standard automated perimetry. Investigative Ophthalmol Vis Sci. 2011;52:5523–23.

    Google Scholar 

  65. Chouchou F, Pichot V, Pepin JL, Tamisier R, Celle S, Maudoux D, et al. Sympathetic overactivity due to sleep fragmentation is associated with elevated diurnal systolic blood pressure in healthy elderly subjects: the PROOF-SYNAPSE study. Eur Heart J. 2013;34:2122–31.

    Article  CAS  PubMed  Google Scholar 

  66. Peled N, Greenberg A, Pillar G, Zinder O, Levi N, Lavie P. Contributions of hypoxia and respiratory disturbance index to sympathetic activation and blood pressure in obstructive sleep apnea syndrome. Am J Hypertens. 1998;11:1284–9.

    Article  CAS  PubMed  Google Scholar 

  67. Smagula SF, Stone KL, Redline S, Ancoli-Israel S, Barrett-Connor E, Lane NE, et al. Actigraphy- and polysomnography-measured sleep disturbances, inflammation, and mortality among older men. Psychosom Med. 2016;78:686–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Perez-Rico C, Gutierrez-Diaz E, Mencia-Gutierrez E, Diaz-de-Atauri MJ, Blanco R. Obstructive sleep apnea-hypopnea syndrome (OSAHS) and glaucomatous optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2014;252:1345–57.

    Article  PubMed  Google Scholar 

  69. Faridi O, Park SC, Liebmann JM, Ritch R. Glaucoma and obstructive sleep apnoea syndrome. Clin Exp Ophthalmol. 2012;40:408–19.

    Article  PubMed  Google Scholar 

  70. Meier-Ewert HK, Ridker PM, Rifai N, Regan MM, Price NJ, Dinges DF, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004;43:678–83.

    Article  CAS  PubMed  Google Scholar 

  71. Phillips CL, Yang Q, Williams A, Roth M, Yee BJ, Hedner JA, et al. The effect of short-term withdrawal from continuous positive airway pressure therapy on sympathetic activity and markers of vascular inflammation in subjects with obstructive sleep apnoea. J Sleep Res. 2007;16:217–25.

    Article  PubMed  Google Scholar 

  72. Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation. 2003;107:1129–34.

    Article  CAS  PubMed  Google Scholar 

  73. Blondeau P, Tetrault JP, Papamarkakis C. Diurnal variation of episcleral venous pressure in healthy patients: a pilot study. J Glaucoma. 2001;10:18–24.

    Article  CAS  PubMed  Google Scholar 

  74. Kiekens S, Veva DeG, Coeckelbergh T, Tassignon MJ, van de Heyning P, Wilfried DeB, et al. Continuous positive airway pressure therapy is associated with an increase in intraocular pressure in obstructive sleep apnea. Invest Ophthalmol Vis Sci. 2008;49:934–40.

    Article  PubMed  Google Scholar 

  75. Pépin JL, Chiquet C, Tamisier R, Lévy P, Almanjoumi A, Romanet JP. Frequent loss of nyctohemeral rhythm of intraocular pressure restored by nCPAP treatment in patients with severe apnea. Arch Ophthalmol. 2010;128:1257–63.

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. These authors contributed equally: Alex Jia Yang Cheong, Sean Kang Xuan Wang, Chang Yi Woon.

Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore

    Alex Jia Yang Cheong, Sean Kang Xuan Wang, Chang Yi Woon, Ki Han Yap, Kevin Joo Yang Ng & Flora Wen Xin Xu

  2. Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel

    Uri Alkan

  3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Uri Alkan

  4. Department of Otorhinolaryngology–Head & Neck Surgery, Singapore General Hospital, Singapore, Singapore

    Adele Chin Wei Ng, Anna See, Shaun Ray Han Loh & Song Tar Toh

  5. Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore

    Tin Aung

  6. Duke-NUS Medical School, Singapore, Singapore

    Tin Aung & Song Tar Toh

  7. Surgery Academic Clinical Program, SingHealth, Singapore, Singapore

    Song Tar Toh

  8. Singhealth Duke-NUS Sleep Centre, Singhealth, Singapore, Singapore

    Song Tar Toh

Authors
  1. Alex Jia Yang Cheong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sean Kang Xuan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chang Yi Woon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ki Han Yap
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kevin Joo Yang Ng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Flora Wen Xin Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Uri Alkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Adele Chin Wei Ng
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Anna See
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Shaun Ray Han Loh
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tin Aung
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Song Tar Toh
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AJYC, SKXW, CYW, TA and STT designed the study, study protocol and tools. AJYC, SKXW, CYW, KHY, KJYN and FWXX conducted the data collection. AJYC, UA, ACWN, AS, SRHL, TA and STT were responsible for analysing and interpreting the data and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Song Tar Toh.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cheong, A.J.Y., Wang, S.K.X., Woon, C.Y. et al. Obstructive sleep apnoea and glaucoma: a systematic review and meta-analysis. Eye (2023). https://doi.org/10.1038/s41433-023-02471-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41433-023-02471-6

Search

Advanced search

Quick links