持续气道正压通气治疗对阻塞性睡眠呼吸暂停患者眼压的影响：一项系统评价和荟萃分析。
The effect of continuous positive airway pressure therapy on intraocular pressure in patients with OSA: a systematic review and meta-analysis.
作者信息
Kongchan Papan, Banhiran Wish, Chirapapaisan Niphon, Kasemsuk Navarat
机构信息
Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
J Clin Sleep Med. 2025 May 1;21(5):907-915. doi: 10.5664/jcsm.11552.
STUDY OBJECTIVES
To assess the effect of continuous positive airway pressure (CPAP) therapy on intraocular pressure in patients with obstructive sleep apnea.
METHODS
The search was performed in Ovid Medline and Embase database, then followed by a manual bibliography search. Abstract search and screening were independently performed followed by eligible full-text versions reviewed. Then disagreements were discussed in a group.
RESULTS
This systematic review and meta-analysis considered 15 studies with 495 participants. The pooled mean intraocular pressure after CPAP therapy shows no significant difference compared to the baseline (mean difference, 0.58 mmHg; 95% confidence interval, -0.33 to 1.19). Subgroup analysis shows significantly higher intraocular pressure after in-laboratory positive airway pressure titration and after long-term CPAP use (mean difference, 4.28 mmHg; 95% confidence interval, 0.91-7.66; mean difference, 0.45 mmHg; 95% confidence interval, 0.07-0.83; respectively). Ocular perfusion pressure was also significantly decreased after CPAP therapy (mean difference, -2.15 mmHg; 95% confidence interval, -3.50 to -0.80). The pooled data showed no significant difference in retinal nerve fiber layer thickness and macular layer thickness.
CONCLUSIONS
After long-term treatment CPAP therapy, there is a significant increase in intraocular pressure in patients with obstructive sleep apnea and a decrease in ocular perfusion pressure, but no significant difference in other ophthalmologic parameters is shown. For this reason, CPAP usage in patients with glaucoma necessitates to be done cautiously.
SYSTEMATIC REVIEW REGISTRATION
Registry: PROSPERO; Name: International Prospective Register of Systematic Reviews; URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022370734; Identifier: CRD42022370734.
CITATION
Kongchan P, Banhiran W, Chirapapaisan N, Kasemsuk N. The effect of continuous positive airway pressure therapy on intraocular pressure in patients with OSA: a systematic review and meta-analysis. . 2025;21(5):907-915.
研究目的
评估持续气道正压通气（CPAP）治疗对阻塞性睡眠呼吸暂停患者眼压的影响。
方法
在Ovid Medline和Embase数据库中进行检索，随后进行手工文献检索。独立进行摘要检索和筛选，之后对符合条件的全文版本进行评审。然后在小组中讨论分歧。
结果
本系统评价和荟萃分析纳入了15项研究，共495名参与者。CPAP治疗后的合并平均眼压与基线相比无显著差异（平均差值，0.58 mmHg；95%置信区间，-0.33至1.19）。亚组分析显示，在实验室气道正压滴定后和长期使用CPAP后眼压显著升高（平均差值，4.28 mmHg；95%置信区间，0.91 - 7.66；平均差值，0.45 mmHg；95%置信区间，0.07 - 0.83）。CPAP治疗后眼灌注压也显著降低（平均差值，-2.15 mmHg；95%置信区间，-3.50至-0.80）。汇总数据显示视网膜神经纤维层厚度和黄斑层厚度无显著差异。
结论
长期接受CPAP治疗后，阻塞性睡眠呼吸暂停患者的眼压显著升高，眼灌注压降低，但其他眼科参数无显著差异。因此，青光眼患者使用CPAP时需谨慎。
系统评价注册
注册库：PROSPERO；名称：国际系统评价前瞻性注册库；网址：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022370734；标识符：CRD42022370734。
引用
Kongchan P, Banhiran W, Chirapapaisan N, Kasemsuk N. 持续气道正压通气治疗对阻塞性睡眠呼吸暂停患者眼压的影响：一项系统评价和荟萃分析。. 2025；21(5):907 - 915。
Zotero 插件