Obstructive sleep apnea and increased risk of glaucoma: a population-based matched-cohort study

Ophthalmology. 2013 Aug;120(8):1559-64. doi: 10.1016/j.ophtha.2013.01.006. Epub 2013 Apr 17.


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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Glaucoma, Open-Angle / diagnosis
  • Glaucoma, Open-Angle / epidemiology
  • Glaucoma, Open-Angle / etiology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / epidemiology
  • Taiwan / epidemiology
  • Urban Population / statistics & numerical data