Floppy Eyelid Syndrome as an Indicator of the Presence of Glaucoma in Patients With Obstructive Sleep Apnea

Muniesa, Marta; Sánchez‐de‐la‐Torre, Manuel; Huerva, Valentín; Lumbierres, Marina; Barbé, Ferrán

doi:10.1097/ijg.0b013e31829da19f

Cited by 49 publications

(29 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With respect to ocular disorders, the presence of glaucoma 25 and keratoconus 26 have been reported to associated with OSA and FES. In our population, however, we did not find a difference in the prevalence of laxity in those using versus not using glaucoma medications.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Risk Factors, and Morbidity of Eye Lid Laxity in a Veteran Population

Ansari

Singh

Alabiad

et al. 2015

Cornea

View full text Add to dashboard Cite

Purpose To study the prevalence, risk factors, and morbidity of eyelid laxity in a veteran population Design Prospective, cross sectional study with retrospective chart review Participants 150 subjects were evaluated from either an outpatient eye or a geriatric clinic at the Miami Veterans Affairs Hospital from June through August 2013. Methods Clinical data were gathered from a questionnaire and a computerized medical record system including demographics, medical history, and ocular irritation history. Upper and lower eyelid laxity was clinically graded. Main Outcome Measures The prevalence of eyelid laxity, risk factors for its presence, and its correlation to ocular surface symptoms. Results Fifty-four percent of participants (n=81) had laxity (grade 1 or higher) in either the upper and/or lower eyelids. Risk factors for eyelid laxity in our population included older age, higher body mass index (BMI), and a diagnosis of sleep apnea. Patients with any eyelid laxity (grade 1 or more in any eyelid) had a 2.23 fold risk of severe ocular surface symptoms (score of 12 or higher on the Dry Eye Questionnaire 5) compared to those without laxity (95% confidence interval (CI) 1.15-4.31, p=0.017), and this was primarily driven by the presence of upper eyelid laxity. Conclusions We found a high prevalence of eyelid laxity in our population, and its presence was associated with significant ocular surface morbidity. This study reinforces the need to incorporate dynamic eyelid testing into the ophthalmic exam in patients with ocular surface discomfort.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence, Risk Factors, and Morbidity of Eye Lid Laxity in a Veteran Population

Ansari

Singh

Alabiad

et al. 2015

Cornea

View full text Add to dashboard Cite

show abstract

“…Thirty-eight of the 45 patients with FES were diagnosed with OSA (85%) and 65% had severe OSA. In another study by the same group, 152 patients were included to investigate whether FES could be an indicator of glaucoma in patients with OSA [94]. There were 75 patients with OSA and without FES; 52 patients with OSA and FES; and 25 non-OSA patients.…”

Section: Floppy Eyelid Syndrome (Fes)mentioning

confidence: 99%

Obstructive sleep apnoea

West

Turnbull

2018

Eye

View full text Add to dashboard Cite

Obstructive sleep apnoea (OSA) is increasing in prevalence due to rising obesity. While OSA is a disorder primarily of the upper airway during sleep, its pathophysiological impact on other body systems is increasingly recognised. There has been interest in the prevalence of OSA in different ophthalmic conditions and possible causation has been postulated. As OSA is common, it can be expected that people with co-existent OSA will be found in any ophthalmic disease population studied. To determine with confidence the significance of finding patients with OSA in a particular cohort requires a well matched control group, ideally matched for age, obesity, gender and co-morbidities. Only if one can say with certainty that the prevalence of OSA is higher in a group with a particular co-existent ophthalmic disease can we begin to speculate about possible mechanisms for the overlap in these conditions. Possible mechanisms for how OSA might affect the eye are discussed in this review. The current literature is reviewed with respect to diabetic retinopathy, glaucoma, floppy eyelid syndrome, non-arteritic ischaemic optic neuropathy, keratoconus and AMD. Associations with OSA have been found, but robust prospective studies using multi-channel sleep studies to diagnose OSA are lacking. Gaps remain in the evidence and in our knowledge. It is hoped that this review will highlight the need for ophthalmologists to consider OSA in their patients. It also makes recommendations for future research, especially to consider whether therapies for OSA can also be effective for ophthalmic disorders.

show abstract

“…[27] investigated the prevalence of glaucoma in OSA with and without FES. Glaucoma was defined as asymmetric cupping, glaucomatous optic disc damage with corresponding VFs, thinner neuroretinal rim, and/or optic disc hemorrhage and/or with RNFL defects.…”

Section: Prevalence Of Glaucoma In Patients With Obstructive Sleep Apneamentioning

confidence: 99%

Glaucoma and its association with obstructive sleep apnea: A narrative review

et al. 2016

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is one of the systemic risk factors for glaucoma which causes irreversible visual field (VF) damage. We reviewed the published data of all types of studies on the association between these two conditions and papers regarding functional and structural changes related to glaucomatous damage using Scopus, web of science, and PubMed databases. There is evidence that the prevalence of glaucoma is higher in OSA patients, which independent of intraocular pressure (IOP). Studies have reported thinning of retinal nerve fiber layer (RNFL), alteration of optic nerve head, choroidal and macular thickness, and reduced VF sensitivity in patients of OSA with no history glaucoma. A negative correlation of apnea-hypopnea index with RNFL and VF indices has been described in some studies. Raised IOP was noted which is possibly related to obesity, supine position during sleep, and raised intracranial pressure. Diurnal fluctuations of IOP show more variations in OSA patients before and after continuous positive airway pressure (CPAP) therapy when compared with the normal cases. The vascular factors behind the pathogenesis include recurrent hypoxia with increased vascular resistance, oxidative stress damage to the optic nerve. In conclusion, comprehensive glaucoma evaluation should be recommended in patients with OSA and should also periodically monitor IOP during CPAP treatment which may trigger the progression of glaucomatous damage.

show abstract

Floppy Eyelid Syndrome as an Indicator of the Presence of Glaucoma in Patients With Obstructive Sleep Apnea

Abstract: These data suggest that FES may offer a useful way to identify individuals with a greater probability of having glaucoma in the OSA population.

Cited by 49 publications

References 24 publications

Prevalence, Risk Factors, and Morbidity of Eye Lid Laxity in a Veteran Population

Prevalence, Risk Factors, and Morbidity of Eye Lid Laxity in a Veteran Population

Obstructive sleep apnoea

Glaucoma and its association with obstructive sleep apnea: A narrative review

Contact Info

Product

Resources

About