Blazes Marian, Ngadisastra Caitlyn, Li Pei-Ru, Lee Cecilia S, Lee Jiahn-Shing, See Lai-Chu, Lin Ken-Kuo
Department of Ophthalmology, University of Washington, Seattle, Washington.
Roger and Angie Karalis Johnson Retina Center, Seattle, Washington.
Retina. 2025 Feb 1;45(2):198-206. doi: 10.1097/IAE.0000000000004293.
Obstructive sleep apnea (OSA) may increase the risk of age-related macular degeneration (AMD) due to repetitive oxygen deprivation or other mechanisms, though whether OSA increases the risk of AMD progression is unknown. The authors analyzed associations between OSA and AMD risk in the Taiwanese population.
The authors identified patients diagnosed with OSA between 2000 and 2018 in the Taiwan National Health Insurance Research Database and used 1:1 propensity score matching on demographics and comorbidities to create a non-OSA cohort. The authors used Cox proportional hazard modeling to investigate the risk of AMD and the risk of progression from nonexudative to exudative AMD in OSA versus non-OSA patients.
A total of 66,869 OSA patients were matched with 66,869 non-OSA patients. The hazard ratio of AMD in the OSA cohort was 1.36 (95% confidence interval, 1.29-1.43, P < 0.0001). The hazard ratio for progression from nonexudative to exudative AMD for the OSA cohort was 0.94 (95% confidence interval, 0.77-1.14, P = 0.5073).
Obstructive sleep apnea is associated with a higher risk of developing AMD. However, no increased risk of AMD progression is observed among people with OSA and existing nonexudative AMD.
阻塞性睡眠呼吸暂停（OSA）可能由于反复缺氧或其他机制增加年龄相关性黄斑变性（AMD）的风险，尽管OSA是否会增加AMD进展的风险尚不清楚。作者分析了台湾人群中OSA与AMD风险之间的关联。
作者在台湾国民健康保险研究数据库中识别出2000年至2018年间被诊断为OSA的患者，并根据人口统计学和合并症进行1:1倾向评分匹配，以创建一个非OSA队列。作者使用Cox比例风险模型来研究OSA患者与非OSA患者中AMD的风险以及从非渗出性AMD进展为渗出性AMD的风险。
总共66,869名OSA患者与66,869名非OSA患者进行了匹配。OSA队列中AMD的风险比为1.36（95%置信区间，1.29 - 1.43，P < 0.0001）。OSA队列中从非渗出性AMD进展为渗出性AMD的风险比为0.94（95%置信区间，0.77 - 1.14，P = 0.5073）。
阻塞性睡眠呼吸暂停与发生AMD的较高风险相关。然而，在患有OSA和现有非渗出性AMD的人群中，未观察到AMD进展风险增加。
