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Abstract #49059 Published in IGR 14-1
Glaucoma and obstructive sleep apnea syndrome
Faridi O; Park SC; Liebmann JM; Ritch RClinical and Experimental Ophthalmology 2012; 40: 408-419
Glaucoma is increasingly becoming recognized as a manifestation of both ocular and systemic risk factors. Risk factors in addition to intraocular pressure (IOP) are increasingly being identified and play a critical role in the development and/or progression of glaucoma. Particularly in the lower ranges of IOP, a number of disorders associated with reduced blood flow and ischemia, collectively termed vascular risk factors, such as migraine, Raynaud's phenomenon, atrial fibrillation, and reduced nocturnal blood pressure, lead to decreased ocular perfusion pressure. During sleep, alterations occur in cardiovascular physiology that are balanced by auto-regulatory mechanisms to maintain homeostasis. However, in obstructive sleep apnea (OSA), the normal physiologic balance is upset, leading to hypoxia and sympathetic activation. OSA can range from mild to severe, and, therefore, its associations and their severity may depend on the severity of the sleep apnea. A potentially modifiable systemic risk factor, OSA has recently been increasingly associated with glaucoma, is independent of IOP. Through hypoxia-mediated damage to blood vessels and their compensatory mechanisms, OSA may alter blood flow to the optic nerve head and, in combination with other predisposing factors, lead to decreased ocular perfusion pressure. This in turn may directly affect the optic nerve or it may indirectly increase its susceptibility to other insults. The purpose of this review is to shed light on the association between OSA and glaucoma.
Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY; Department of Ophthalmology, The New York Medical College, Valhalla, NY; Department of Ophthalmology, New York University School of Medicine, New York, NY.
Full articleClassification:
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.2.2 Other risk factors for glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)