The relationship between obstructive sleep apnea syndrome and glaucoma

Purpose: To investigate the prevalance and tendency of glaucoma in patients with obstructive sleep apnea syndrome (OSAS) by using Heidelberg Retina Tomography (HRT), Optical Coherence Tomography (OCT) and computerized visual field analyzer.Patients and Methods: Sixty-four patients with OSAS and 32 controls were comprised the study group. Detailed ophthalmological examinations, computerized visual field analyzer, HRT III and OCT were performed on study group. Twenty four hours pattern of intraocular pressure (IOP) were measured on OSAS group. Retinal nerve fibre layer (RNFL) changes were followed in patients with tendency of glaucoma. OSAS patients were divided into three groups for severity of disease by AHI.Results: There was a statistically significant correlation among AHI (Apnea-hypopnea Index), MD (Mean deviation) and RNFL thickness (p<0.05). Glaucoma was diagnosed in eight patients and the prevalance of glaucoma was 12.5% in the group of patients with OSAS. One patients had primary open angle glaucoma (POAG) and seven had normal tension glaucoma (NTG). Five of all patients with glaucoma were in severe OSAS group and this was found statistically significantly (p=0.033). There was a statistically significant difference between first and last follow-up examination for RNFL thickness in patients with glaucoma tendency (p=0.007).Conclusion: This results suggest that the patients with OSAS were related with NTG. These patients have to be followed carefully for glaucoma development and progression. In follow-up examinations, blue-yellow perimetry should be performed for detected early visual field defects and RNFL thickness measurements were performed in patients with glaucoma tendency. Detecting severe OSAS in most of the patients with glaucoma was important.Key words: Computerized visual field analyzer, glaucoma, Heidelberg Retinal Tomography III, Obstructive Sleep Apnea Syndrome, Optical Coherence Tomography, Polysomnography