<p>Neuro-Ophthalmological Manifestations of Obstructive Sleep Apnea: Current Perspectives</p>

Abstract

Obstructive sleep apnea (OSA) is a disease of obstructed airways during sleep that significantly impacts the quality of life and increases the risk of various systemic diseases. OSA has been studied as a risk factor for a number of neuro-ophthalmic conditions and a strong relationship has been established with non-arteritic anterior ischemic optic neuropathy (NAION). The incidence of glaucoma and stroke have also been significantly associated with OSA and are conditions that may also be seen by neuro-ophthalmologists. Patients with NAION have a significantly higher incidence of OSA and OSA diagnosis significantly increases the risk for NAION development. Non-compliance with continuous positive airway pressure (CPAP) in OSA patients has also been found to be a risk factor for fellow-eye involvement and there is increasing evidence to suggest that every patient with NAION should be formally evaluated with polysomnography. The relationship between OSA and idiopathic intracranial hypertension (IIH) has also been studied, but the relationship between these two conditions is less clear. There is insufficient evidence to recommend routine eye examinations in OSA patients for papilledema and conducting a sleep study for a newly diagnosed IIH patient should be left to the discretion of the clinician based on other symptoms and risk factors of OSA.

Pediatric Ocular Health and Obstructive Sleep Apnea Syndrome: A Review

“…In adults, OSA increases the risk of glaucoma, ischemic optic neuropathy [25,26], and floppy eyelid syndrome [17,27]. "Self-reported snoring" is associated with reduced retinal thickness and vascular density [28].…”

From Provider to Advocate: The Complexities of Mild Traumatic Brain Injury Prompt the Evolution of Provider Engagement

“…Sleep apnea can be associated with floppy eyelid syndrome [76] and it behooves the VCP to evaluate patients for this condition because it can cause irritated eyes or even cornea abrasions during sleep. Notably, an association between sleep apnea and intracranial hypertension has been suggested; although the relationship between these two conditions may not be sufficient to recommend fundus examinations on every patient with sleep apnea [77], it seems reasonable for VCPs to look for papilledema in all of their sleep apnea patients.…”

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

“…Previous studies showed an association of OSA with an increased risk of cardiovascular and cerebrovascular diseases, stroke, coronary artery disease, diabetes, hypercholesterolemia and hypertension [ 5 , 6 , 7 , 8 ]. Furthermore, OSA has been shown to be a major risk factor concerning optic nerve disorders, such as glaucoma, non-arteritic anterior ischemic optic neuropathy, central serous chorioretinopathy, papilledema and retinal vein occlusion [ 9 , 10 , 11 ]. The term “glaucoma” describes a collection of progressive, chronic optic neuropathies resulting from the degeneration of retinal ganglion cells and leading to visual impairment.…”