The Veterans Affairs Continuous Positive Airway Pressure Use and Diabetic Retinopathy Study

Optom Vis Sci. 2019 Nov;96(11):874-878. doi: 10.1097/OPX.0000000000001446.

Abstract

Significance: Obstructive sleep apnea has been linked to the development and progression of diabetic retinopathy. In this study, diabetic patients compliant with continuous positive airway pressure therapy (CPAP) for sleep apnea were less likely to have retinopathy, emphasizing the benefits and potential therapeutic role of CPAP in individuals with both conditions.

Purpose: The aim of this study was to compare the prevalence of diabetic retinopathy in type 2 diabetic patients with obstructive sleep apnea who were compliant with CPAP therapy with those who were not compliant with CPAP therapy.

Methods: A retrospective cross-sectional review of type 2 diabetic patients using CPAP for obstructive sleep apnea was conducted. The prevalence of retinopathy was identified, and groups with and without retinopathy were compared using univariate analyses and multivariate logistic regression.

Results: The prevalence of retinopathy was 19.6% (n = 321). Retinopathy was significantly less prevalent in those compliant with CPAP (odds ratio, 0.54; 95% confidence interval, 0.31 to 0.94; P = .04). The relationship remained statistically significant when adjusting for other factors known to impact the course of diabetic eye disease.

Conclusions: Increased CPAP compliance may mitigate the risk of developing diabetic retinopathy in type 2 diabetic patients with obstructive sleep apnea.

MeSH terms

  • Adult
  • Continuous Positive Airway Pressure*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Retinopathy / prevention & control*
  • Disease Progression
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Compliance
  • Prevalence
  • Respiratory Therapy*
  • Retrospective Studies
  • Sleep Apnea, Obstructive / therapy*
  • United States
  • Veterans