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Abstract #104968 Published in IGR 23-2
Association between Risk of Obstructive Sleep Apnea and Glaucoma: The Singapore Epidemiology of Eye Disease Study
Mehta A; Man REK; Gan A; Najjar RP; Nongpiur M; Lamoureux EL; Cheng CY; Fenwick EKJournal of Glaucoma 2022; 31: 935-940
PRECIS: In this population-based, cross-sectional study of Indian and Malay adults in Singapore aged ≥40 years, intermediate or high risk of obstructive sleep apnea was associated with 50% higher odds of having glaucoma. BACKGROUND/AIMS: The relationship between obstructive sleep apnea (OSA) and glaucoma is unclear. We assessed the association between the risk of OSA and glaucoma in an Asian population. METHODS: In this population-based, cross-sectional study, we included Indian and Malay adults aged ≥40 years recruited between 2011-2015. Glaucoma was assessed by trained ophthalmologists and classified into primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG). OSA risk was assessed with the Snoring, Tiredness, Observed apnea, High blood pressure, Body mass index, Age, Neck circumference, and male Gender (STOP-Bang) questionnaire and categorized as low risk (<3) or intermediate/higher risk (≥3). We used multivariable logistic regression models to evaluate the relationship between risk of OSA and glaucoma adjusted for key variables, and further stratified for subtype and ethnicity. RESULTS: Of the 3,126 participants (mean age: 63.1±9.6 y; 52.5% female), 134 (4.3%) had glaucoma, comprising 86 (2.8%) POAG, 22 (0.7%) PACG and 26 (0.8%) secondary glaucomas, and 1,182 (37.8%) had an intermediate/higher risk of OSA. Compared to individuals with a low risk of OSA, individuals with intermediate/higher risk had 50% greater odds of having glaucoma (odds ratio: OR 1.55, 95% Confidence Interval: CI 1.03-2.33; P=0.035). We observed a non-significant increase in likelihood of having POAG in those with intermediate/higher risk of OSA compared to those with low risk. The OSA-glaucoma relationship was modified by ethnicity, with Malays with intermediate/higher risk of OSA having a 2-fold risk of having any glaucoma (OR 2.01, 95% CI [confidence interval]: 1.12, 3.59 P=0.019); while the same elevated risk was not observed for Indians. CONCLUSIONS: Intermediate or high risk of OSA is associated with 50% higher odds of having glaucoma in our Singaporean population, with a 2-fold higher risk of glaucoma observed in Malays (but not Indians); however a confirmational sleep study is needed.
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