Obstructive Sleep Apnea Assessed by Overnight Polysomnography in Patients With Keratoconus.

PURPOSE: To determine the prevalence of obstructive sleep apnea (OSA) in patients with keratoconus (KCN) and to evaluate the association between the severity of KCN and OSA. METHODS: OSA was diagnosed with an overnight home sleep apnea test. As estimated by home monitoring, an apnea-hypopnea index threshold of ≥5 sleep-related obstructive breathing events per hour was considered suggestive of OSA. For grading KCN severity (Amsler-Krumeich classification), slit-lamp biomicroscopy, corneal topography, and pachymetry measurements were performed. Preoperative measurements were included in the analysis for patients who had undergone surgery for KCN. RESULTS: The study sample consisted of 50 consecutively enrolled patients: 33 men; mean age ± SD 43.6 ± 11.8 years; body mass index 29.7 ± 7.3 kg/m; and neck circumference 40.0 ± 3.4 cm. The overall prevalence of OSA was 38% (6 women and 13 men). Patients with OSA were older (49.8 ± 9.3 vs. 37.5 ± 10.8 years; P < 0.01) and had a higher body mass index (34.7 ± 8.1 vs. 26.2 ± 4.8 kg/m; P <0.01), neck circumference (41.2 ± 2.6 vs. 38.7 ± 3.6 cm; P < 0.01), and cylinder diopter (5.98 ± 1.94 vs. 4.05 ± 3.55 D; P = 0.045) compared with those without OSA. No significant association was found between OSA severity and ocular parameters and KCN grade. CONCLUSIONS: As measured by overnight home sleep apnea testing, OSA was 10 to 20 times more prevalent among patients with KCN than the rate reported for the general population. The rate lies between the prevalence estimated from sleep study data of self-reported diagnosis of OSA and the risk of developing OSA as determined by the Berlin Questionnaire.

Prevalence and risk factors of eye diseases in adult patients with obstructive sleep apnoea: results from the SLE.E.P.Y cohort study.

OBJECTIVES: To assess the occurrence of glaucoma, eyelid, corneal and macular disorders in a cohort of patients with obstructive sleep apnoea (OSA) diagnosed by overnight polysomnography and to investigate into the risk factors for the above eye diseases (EDs). DESIGN: Cross-sectional cohort study between 2014 and 2015. SETTING: Unit of Respiratory Medicine and Eye Clinic of the University of Verona. PARTICIPANTS: 431 consecutive patients were considered eligible. Of these, 87 declined to participate, 35 were untraceable and 13 were deceased. INTERVENTIONS: A complete ophthalmic evaluation of both eyes for each patient. PRIMARY AND SECONDARY OUTCOME MEASURES: Best-corrected distance visual acuity, intraocular pressure, corneal, macular and optic nerve optical coherence tomography, ocular aberrometry, optic nerve laser polarimetry, visual field test, and eyelid examination. RESULTS: 296 patients aged 64.5±12.8 years, 23% female and 77% male, underwent ophthalmic examination. There was 56% (n=166) prevalence of eyelid disorders, 27% (n=80) of corneal disorders, 13% (n=39) of macular disorders and 11% (n=33) of glaucoma. Advancing age was not associated with the severity of OSA, while significant differences were found for gender, body mass index, Oxygen Desaturation Index, smoking habit, hypertension and diabetes. Severe OSA was significantly associated with glaucoma (OR, 95% CI 1.05 to 5.93, p=0.037). CONCLUSIONS: EDs were more prevalent in our patinets with OSA than in the general population. Severe Apnoea/Hypopnoea Index level seemed to play a role as risk factor only for glaucoma.