The Associations of Obstructive Sleep Apnea and Eye Disorders: Potential Insights into Pathogenesis and Treatment

Abstract

Purpose of Review Obstructive sleep apnea (OSA) patients are at significantly increased risks for cardiovascular and cerebrovascular morbidities. Recently, there has been heightened interest in the association of OSA with numerous ocular diseases and possible improvement of these conditions with the initiation of OSA treatment. We reviewed the current evidence with an emphasis on the overlapping pathogeneses of both diseases. Recent Findings Currently available literature points to a substantial association of OSA with ocular diseases, ranging from those involving the eyelid to optic neuropathies and retinal vascular diseases. Since the retina is one of the highest oxygen-consuming tissues in the body, the intermittent hypoxia and hypercapnia ensuing in OSA can have deleterious effects on ocular function and health. Tissue hypoxia, autonomic dysfunction, microvascular dysfunction, and inflammation all play important roles in the pathogenesis of both OSA and ocular diseases. Whether OSA treatment is capable of reversing the course of associated ocular diseases remains to be determined. It is anticipated that future therapeutic approaches will target the common underlying pathophysiologic mechanisms and promote favorable effects on the treatment of known associated ocular diseases. Summary Emerging evidence supports the association of ocular diseases with untreated OSA. Future studies focusing on whether therapeutic approaches targeting the common pathophysiologic mechanisms will be beneficial for the course of both diseases are warranted.

Pediatric Ocular Health and Obstructive Sleep Apnea Syndrome: A Review

“…In summary, studies in adults suggest that OSAS is clearly associated with ocular risks such as glaucoma, ischemic optic neuropathy, floppy eyelid syndrome, and various retinal and corneal alterations [16,17,25,[28][29][30][31][32][33]. In pediatric patients with OSAS, studies show similar ocular changes, including optic nerve thickness, choroidal layer, retinal vascularization, and cornea, with evidence of improvements in retinal vascularization after treatment [18][19][20][21][22][23].…”

“…Patients with OSAS exhibit reduced RNFL thickness, Ganglion Cell Complex (GCC) thickness, and perifoveal vascular density, accompanied by retinal and optic nerve ischemic injury [28,29]. OSAS may correlate with non-arteritic anterior ischemic optic neuropathy (NAION) through endothelial damage, hypoxia, and reduced perfusion [17,30]. It is linked to dry eye syndrome [17], keratoconus [16,17], and central serous chorioretinopathy.…”

Pediatric Ocular Health and Obstructive Sleep Apnea Syndrome: A Review

“…OSA may be associated with non-arteritic anterior ischemic optic neuropathy (NAION) due to endothelial damage, hypoxia, and reduced perfusion [17]. It is linked to dry eye syndrome [17,31], keratoconus [16,17], and central serous chorioretinopathy. OSA heightens the risk of retinal vein occlusion (RVO) and diabetic retinopathy [17,32], causing damage to retinal vessels [17,32].…”