Amaral Dillan Cunha, Magalhães Pedro Lucas Machado, Alfatih Muhammad, Miranda Bruna Gabriel, Abu Serhan Hashem, Jacometti Raíza, Ferreira Bruno Fortaleza de Aquino, Sant'Ana Letícia, Santos Diogo Haddad, Monteiro Mário Luiz Ribeiro, Louzada Ricardo Noguera
Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-853, RJ, Brazil.
Faculty of Medicine, Institute of Medical Education, Angra dos Reis 23914-360, RJ, Brazil.
Vision (Basel). 2025 Aug 1;9(3):65. doi: 10.3390/vision9030065.
Obstructive sleep apnea (OSA) is a common condition associated with intermittent hypoxia, systemic inflammation, and vascular dysfunction; mechanisms implicated in retinal disease pathogenesis. This real-world retrospective cohort study used data from the TriNetX Research Network to assess whether continuous positive airway pressure (CPAP) therapy reduces retinal disease incidence among adults with OSA and BMI between 25.0 and 30.0 kg/m. After 1:1 propensity score matching, 101,754 patients were included in the analysis. Retinal outcomes included diabetic retinopathy (DR), age-related macular degeneration (AMD), retinal vein occlusion (RVO), and central serous chorioretinopathy (CSC). CPAP use was associated with a modest but statistically significant reduction in DR (3.2% vs. 3.4%, RR: 0.922, = 0.016) and AMD (2.1% vs. 2.3%, RR: 0.906, = 0.018), while no significant differences were found for RVO or CSC. These findings support prior evidence linking CPAP to improved retinal microvascular health and suggest a protective effect against specific retinal complications. Limitations include a lack of data on CPAP adherence, OSA severity, and imaging confirmation. Still, this study highlights the importance of interdisciplinary care between sleep and eye health, and the need for further prospective studies to validate CPAP's role in preventing retinal disease progression in OSA patients.
阻塞性睡眠呼吸暂停（OSA）是一种常见病症，与间歇性缺氧、全身炎症和血管功能障碍相关；这些机制与视网膜疾病的发病机制有关。这项真实世界的回顾性队列研究使用了TriNetX研究网络的数据，以评估持续气道正压通气（CPAP）治疗是否能降低体重指数在25.0至30.0kg/m之间的成年OSA患者的视网膜疾病发病率。在进行1:1倾向评分匹配后，101754名患者被纳入分析。视网膜结局包括糖尿病性视网膜病变（DR）、年龄相关性黄斑变性（AMD）、视网膜静脉阻塞（RVO）和中心性浆液性脉络膜视网膜病变（CSC）。使用CPAP与DR（3.2%对3.4%，RR：0.922， =0.016）和AMD（2.1%对2.3%，RR：0.906， =0.018）的适度但具有统计学意义的降低相关，而RVO或CSC未发现显著差异。这些发现支持了先前将CPAP与改善视网膜微血管健康联系起来的证据，并表明对特定视网膜并发症具有保护作用。局限性包括缺乏关于CPAP依从性、OSA严重程度和影像学确认的数据。尽管如此，本研究强调了睡眠与眼部健康之间跨学科护理的重要性，以及需要进一步的前瞻性研究来验证CPAP在预防OSA患者视网膜疾病进展中的作用。
