Sleep-disordered breathing a neglected risk factor in primary open-angle glaucoma

Abstract

Background: Sleep-disordered breathing (SDB) is accompanied by large swings in blood pressureand the repetitive hypoxic period during sleep, which may accelerate anoxic optic nerve damageseen in glaucoma. There are many associated risk factors in primary open-angle glaucoma (POAG),but recently, SDB, though a neglected one, is coming up as a risk factor. However, various studieshave reported controversial findings. Objective: To evaluate the relationship between SDB andPOAG. Design: A hospital-based case-control study. Methods: A total of 400 patients between 30–70 years were recruited from eye OPD between 2008- 2010. They were divided into two groups, 200cases with established POAG and 200 age and sex-matched healthy subjects with normal IOP in thecontrol group. Detailed history, complete ophthalmic and ENT examination was made along withBMI, blood pressure and neck girth measurement. Both groups were interviewed with aquestionnaire regarding SDB and were recorded on the Epworth sleepiness scale (ESS). Results:The mean age being 55.02 ± 8.66 in the POAG group and male predominance noted both in POAGand SDB patients with ESS> 10 was statistically significant (p < 0.05). Also, patients in the POAGgroup with ESS > 10 had more IOP and BMI, greater neck girth, high BP and more ENT problemswith p-value < 0,001, which is highly significant, thus showing the relationship between SDB andPOAG. Conclusions: Increased community awareness and earlier detection of glaucoma and itscorrelation with SDB results in decreased morbidity.