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Abstract #19048 Published in IGR 3-1
Normal tension glaucoma, sleep apnea syndrome and nasal continuous positive airway pressure therapy: case report and literature review
Kremmer S; Selbach JM; Ayertey HD; Steuhl KPKlinische Monatsblätter für Augenheilkunde 2001; 218: 262-268
BACKGROUND: In the pathogenesis of glaucoma, besides an elevated intraocular pressure (IOP), cardiovascular risk factors, such as arterial hypotension and hypertension, vasospasms, autoregulatory defects, atherosclerosis, and diabetes mellitus, are of increasing importance, especially in normal-tension glaucoma (NTG). Recently, there have been several reports of an additional risk factor: obstructive sleep apnea syndrome. METHODS: Literature review (Medline) and case report. RESULTS: The authors report on an 8.5-year follow-up of a 60-year-old patient with NTG. Despite successful pharmacological and surgical lowering of IOP, progressive glaucomatous damage with optic nerve atrophy and increasing visual field defects occurred. As a result of intensive investigations of possible cardiovascular risk factors, obstructive sleep apnea syndrome was diagnosed. Since the start of therapy with nasal continuous positive airway pressure (nCPAP), more than 3.5 years earlier, no further progression of glaucomatous optic nerve damage or visual field defects have been observed. CONCLUSIONS: In clinical practice, obstructive sleep apnea syndrome is often underdiagnosed. In patients suffering from glaucoma and obstructive sleep apnea syndrome, IOP lowering therapy may not be enough, whereas additional nCPAP therapy could potentially prevent the start/progression of glaucomatous optic nerve damage. LA: German
Dr S. Kremmer, Zentrum für Augenheilkunde, Abteiling für Erkrankungen des vorderen Augenabschnitts, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen, Germany. stephan.kremmer@uni-essen.de
Classification:
9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
