Incidence and progression of age-related macular degeneration among patients with and without obstructive sleep apnea: a national cohort study.

Purpose: Obstructive sleep apnea (OSA) may increase the risk of age-related macular degeneration (AMD) due to repetitive oxygen deprivation or other mechanisms, though whether OSA increases the risk of AMD progression is unknown. We analyzed associations between OSA and AMD risk in the Taiwanese population.

Methods: We identified patients diagnosed with OSA between 2000 and 2018 in the Taiwan National Health Insurance Research Database and used 1:1 propensity score matching on demographics and co-morbidities to create a non-OSA cohort. We used Cox proportional hazard modeling to investigate the risk of AMD and the risk of progression from nonexudative to exudative AMD in OSA versus non-OSA patients.

Results: A total of 66,869 OSA patients were matched with 66,869 non-OSA patients. The hazard ratio (HR) of AMD in the OSA cohort was 1.36 (95% confidence interval[CI]: 1.31-1.43, p<.0001). The HR for progression from nonexudative to exudative AMD for the OSA cohort was 0.94 (95%CI: 0.77-1.14, p=0.5073).

Conclusion: OSA is associated with a higher risk of developing AMD. However, no increased risk of AMD progression is observed among people with OSA and existing non-exudative AMD.