Elsevier

Ophthalmology

Volume 120, Issue 8, August 2013, Pages 1559-1564
Ophthalmology

Original article
Obstructive Sleep Apnea and Increased Risk of Glaucoma: A Population-Based Matched-Cohort Study

https://doi.org/10.1016/j.ophtha.2013.01.006Get rights and content

Purpose

Previous studies had reported an increased prevalence of glaucoma in patients with obstructive sleep apnea (OSA). However, the risk of open-angle glaucoma (OAG) among patients with OSA remains unclear. Using a nationwide, population-based dataset in Taiwan, this study aimed to examine the prevalence and risk of OAG among patients with OSA during a 5-year follow-up period after a diagnosis of OSA.

Design

A retrospective, matched-cohort study.

Participants and Controls

This study used data sourced from the Longitudinal Health Insurance Database 2000. We included 1012 subjects with OSA in the study cohort and randomly selected 6072 subjects in the comparison group.

Methods

Each subject in this study was individually traced for a 5-year period to identify those subjects who subsequently received a diagnosis of OAG. Cox proportional hazards regression was performed to calculate the 5-year risk of OAG between the study and comparison cohorts.

Main Outcome Measures

The incidence and risk of OAG between the study and comparison groups.

Results

During the 5-year follow-up period, the incidence rate per 1000 person-years was 11.26 (95% confidence interval [CI], 8.61–14.49) and 6.76 (95% CI, 5.80–7.83) for subjects with and without OSA, respectively. After adjusting for monthly income, geographic region, diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, renal disease, hypothyroidism, and the number of outpatient visits for ophthalmologic care during the follow-up period, stratified Cox proportional hazards regression revealed that the hazard ratio for OAG within the 5-year period for subjects with OSA was 1.67 (95% CI, 1.30–2.17; P<0.001) that of comparison subjects.

Conclusions

Our results suggest that OSA is associated with an increased risk of subsequent OAG diagnosis during a 5-year follow-up period.

Financial Disclosures(s)

The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Section snippets

Database

The data used in this study were sourced from the Longitudinal Health Insurance Database 2000 (LHID2000), which is derived from the Taiwan National Health Insurance (NHI) program and maintained by the Taiwan National Health Research Institute, includes the registration files and original claims data for the reimbursement of 1 000 000 beneficiaries under the NHI program. These 1 000 000 beneficiaries were randomly selected from the year 2000 Registry of Beneficiaries (n = 23.72 million) of the

Results

Table 1 shows the distribution of demographic characteristics and comorbidities between the study cohort and the comparison cohort. Of the total of 6072 subjects, the mean age was 56.0 years (standard deviation, 11.9) and 60% were male. After matching for gender, age group, and urbanization level, subjects with OSA had a higher prevalence of the following comorbidities than comparison subjects: hypertension (P<0.001), diabetes (P<0.001), coronary heart disease (P<0.001), hyperlipidemia (P

Discussion

We found that patients with OSA were independently associated with a 1.67 times increased risk of OAG diagnosis within the first 5 years after their diagnosis, after adjusting for monthly income, diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, renal disease, hypothyroidism, and the number of outpatient visits for ophthalmologic care during the follow-up period.

Several previous studies exploring the link between OSA and OAG were cross-sectional or retrospective in nature

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    Manuscript no. 2012-1417.

    Financial Disclosures: The authors have no proprietary or commercial interest in any of the materials discussed in this article.

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