Obstructive sleep apnoea and increased risk of non-arteritic anterior ischaemic optic neuropathy

Br J Ophthalmol. 2019 Aug;103(8):1123-1128. doi: 10.1136/bjophthalmol-2018-312910. Epub 2018 Nov 9.

Abstract

Background/aims: To determine whether the development of non-arteritic anterior ischaemic optic neuropathy (NAION) is increased among patients newly diagnosed with obstructive sleep apnoea (OSA) in a large general population.

Methods: A 12-year nationwide, population-based, retrospective cohort study including 1 025 340 beneficiaries in the 2002-2013 Korean National Health Insurance Service database was performed. We identified 919 patients newly diagnosed with OSA aged ≥40 years and matched 9190 non-OSA controls using estimated propensity scores in reference to age, sex, demographics, comorbidities and co-medications. We applied Kaplan-Meier curves and Cox proportional hazard models to determine the risk of developing NAION in the OSA group compared with the non-OSA group.

Results: The 10-year incidence probability of NAION was higher in the OSA group (0.92%; 95% CI 0.88 to 0.97) than the non-OSA group (0.42%; 95% CI 0.41 to 0.44, p=0.002, log-rank test). The OSA group was at increased risk of developing NAION compared with the non-OSA group (HR 3.80; 95% CI 1.46 to 9.90) after adjusting for demographics, comorbidities and co-medications.

Conclusions: Our results suggest that patients with newly diagnosed OSA have an increased risk of NAION, although the absolute risk of NAION is low.

Keywords: ischemic optic neuropathy; obstructive sleep apnea.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Optic Neuropathy, Ischemic / epidemiology
  • Optic Neuropathy, Ischemic / etiology*
  • Propensity Score
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Assessment*
  • Risk Factors
  • Sleep Apnea, Obstructive / complications*