Continuous intraocular pressure monitoring in patients with obstructive sleep apnea syndrome using a contact lens sensor

Abstract

PurposeTo analyse nocturnal intraocular pressure (IOP) fluctuations in patients with obstructive sleep apnea syndrome (OSAS) using a contact lens sensor (CLS) and to identify associations between the OSAS parameters determined by polysomnographic study (PSG) and IOP changes. MethodProspective, observational study. Twenty participants suspected of having OSAS were recruited. During PSG study, IOP was monitored using a CLS placed in the eye of the patient. The patients were classified according to the apnea-hypopnea index (AHI) in two categories, severe (>30) or mild/moderate (<30) OSAS. We evaluated several parameters determined by the IOP curves, including nocturnal elevations (acrophase) and plateau times in acrophase (PTs) defined by mathematical and visual methods. ResultsThe IOP curves exhibited a nocturnal acrophase followed by PTs of varying extents at which the IOP remained higher than daytime measurement with small variations. We found significant differences in the length of the PTs in patients with severe OSAS compared to those with mild/moderate disease (P = 0.032/P = 0.028). We found a positive correlation between PTs and OSAS severity measured by the total number of apneic events (r = 0.681/ 0.751 P = 0.004/0.001) and AHI (r = 0.674/0.710, P = 0.004/0.002). Respiratory-related arousal and oxygen saturation also were associated significantly with the IOP PT length. PLOS ONEPLOS ONE | https://doi.org/10.1371/journal.pone.

Effect of CPAP Therapy on 24-Hour Intraocular Pressure-Related Pattern From Contact Lens Sensors in Obstructive Sleep Apnea Syndrome

“…Interestingly, these fluctuations had no impact on the global IOP curves, which showed a similar pattern compared to those obtained in our study involving OSAS patients. As in a recent study by Carnero et al, 29 in which IOP was monitored using a CLS during a PSG study conducted with 20 OSAS patients without CPAP, we observed that patients with severe OSAS showed significant increases in nocturnal IOP values.…”

“…Carnero et al 29 showed that the length of the nocturnal IOP elevation was associated with respiratory parameters that were altered in patients with OSAS, meaning that patients who have better oxygen saturation show shorter nocturnal acrophase. Furthermore, a significant increase in IOP was observed as a response to short-term hypoxia, which returned to the baseline after hypoxia.…”

“…Finally, it has been observed that astrocytes in the optic nerve head are mechanosensitive and can respond to the mechanical stress induced by IOP increase, reducing the trophic support or changes in extracellular remodeling in the optic nerve. 29 The additional increase in IOP associated with CPAP use could explain the risk of glaucoma progression in certain OSAS patients despite them receiving treatment for OSAS with CPAP. 14 …”

A Narrative Review of the Association between Obstructive Sleep Apnea and Glaucoma in Adults

“…The patient cohort was split into severe and mild/moderate OSA. In contrast to Shinmei et al, patients with severe OSA showed a longer IOP elevation compared to patients with a mild/moderate disease ( p = 0.032/ p = 0.028) [ 15 ]. Fang et al investigated the differences in the IOP values during and after varying body positions in OSA and non-OSA patients.…”

Primary open-angle glaucoma in patients with obstructive sleep apnoea in a Colombian population: a cross-sectional study

“…These patients' medical histories were used to determine demographic data such as age and ethnicity as well as family history, arterial hypertension (high blood pressure) and diabetes mellitus histories. The findings in polysomnography determined the severity of OSA using the Apnoea/Hipopnea Index AHI (sum of apnoea and hypopnea events divided by total hours of sleep) to categorise it into one of three groups: mild (index 6-15), moderate (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and severe (>30). 16 Exclusion criteria include psychiatric or neurological disorders, optic neuropathy, anterior ischaemic optic neuropathy, heavy smoking (20 cigarettes per day), alcohol or psychoactive substance abuse, any condition affecting the VF (such as intracranial or ocular lesions), coexisting retinal disease, sequelae of trauma and/or eye inflammation, congenital ocular anatomical alterations, intraocular surgery (with the exception of cataract surgery), history of hypertensive crisis, history of prolonged steroid use, uveitis, bronchial asthma, interstitial lung diseases, heart disease, cirrhosis and chronic renal failure.…”