Friedlander Arthur H, Graves Lindsay L, Chang Tina I, Kawakami K Karl, Lee Urie K, Grabich Shannon C, Fang Zhuang T, Zeidler Michelle R, Giaconi JoAnn A
VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, CA, USA; Hospital Dental Service, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Sep;126(3):226-230. doi: 10.1016/j.oooo.2018.01.021. Epub 2018 Jan 31.
Our objective was to determine primary open-angle glaucoma (POAG) prevalence among obstructive sleep apnea (OSA) patients because the perioperative environment risks further damaging the optic nerve.
We analyzed a "convenience sample" referred by Sleep Medicine for oral appliances because of continuous positive airway pressure intolerance. We determined the aggregate prevalence of the 3 POAG subtypes-"classic" open-angle glaucoma (COAG), normal-tension glaucoma (NTG), and open-angle glaucoma suspect (OAGS)-among the index population and compared it with that of same hospital's general population. Similarly determined were associations between OSA severity levels (apnea-hypopnea index [AHI]) and POAG subtypes.
Among the study sample of 225 patients with OSA (96.4% male; mean age 58.5 ± 12.3 years), 47 (20.9%) had POAG, with a subtype distribution of COAG: 12 (25.5%), NTG: 8 (17.0%), and OAGS: 27 (57.4%). The POAG prevalence rate among medical center's general population was 2.5%, which was significantly less (P < .00001) than among those with comorbid OSA. Severity of the breathing disorder (AHI) failed to identify a significant correlation to any POAG subtype (P > .05).
The significant prevalence of POAG among OSA sufferers suggests need for preoperative consultations from an ophthalmologist to determine eye health and possibly an anesthesiologist to avoid potential vision loss.
我们的目的是确定阻塞性睡眠呼吸暂停（OSA）患者中原发性开角型青光眼（POAG）的患病率，因为围手术期环境有进一步损害视神经的风险。
我们分析了因持续气道正压通气不耐受而由睡眠医学科转诊来使用口腔矫治器的“便利样本”。我们确定了索引人群中3种POAG亚型——“经典”开角型青光眼（COAG）、正常眼压性青光眼（NTG）和开角型青光眼可疑（OAGS）——的总患病率，并将其与同一医院普通人群的患病率进行比较。同样确定的还有OSA严重程度水平（呼吸暂停低通气指数[AHI]）与POAG亚型之间的关联。
在225例OSA患者的研究样本中（96.4%为男性；平均年龄58.5±12.3岁），47例（20.9%）患有POAG，其亚型分布为：COAG：12例（25.5%），NTG：8例（17.0%），OAGS：27例（57.4%）。医疗中心普通人群中的POAG患病率为2.5%，显著低于（P＜.00001）合并OSA的人群。呼吸障碍的严重程度（AHI）与任何POAG亚型均未发现显著相关性（P＞.05）。
OSA患者中POAG的显著患病率表明，术前需要眼科医生进行会诊以确定眼部健康状况，可能还需要麻醉医生会诊以避免潜在的视力丧失。
