The article provides a good summary of preliminary data in the literature that begin to support a relationship between obstructive sleep apnea and specific ocular disorders, and it hypothesizes the pathophysiological mechanisms, he said. OSA has effects on various physiological mechanisms that may affect various organs and physiological systems. Transient changes in blood pressure, intermittent hypoxia, and sympathetic activation are only some of the possible mechanisms OSA could damage.
Explore This IssueJune 2007
Tod C. Huntley, MD, from Head & Neck Surgery Associates in Carmel, IN, who treats a large number of OSA patients, agrees that the topic deserves further study. It is well known that obstructive sleep apnea can have wide-ranging effects on other body systems. The relationships between OSA and hypertension, heart disease, and stroke, for example, are well established and have been studied extensively. The effects that OSA may have on ocular health are less well known but are very intriguing, he told ENToday in an interview.
The CJO article included studies investigating OSA and various eye problems including glaucoma, nonarteritic anterior ischemic optic neuropathy, visual field defects, papilledema, and more. The effects of OSA on body homeostasis provide insight into how OSA can play a role in the pathogenesis of ocular dysfunction. The immediate physiological effects of OSA involve hypoxia, hypercapnia, and inspiratory effort. These factors may directly impact the functioning of the optic nerve or work in concert to manifest as vascular sequelae, the authors wrote.
From an ophthalmology perspective there aren’t enough data to support changes in the management of patients with eye disease and OSA, but there are enough compelling data to warrant further study, according to Graham Trope, MD, an ophthalmologist at the University of Toronto. He was not one of the study authors.
However, he added that if ophthalmologists have patients who are middle-aged and overweight-that is who are OSA suspects-it’s worth referring them for a sleep assessment. It’s certainly worth sending them for sleep assessment because it wi’ll help their sleep problems. Whether it will help their glaucoma, we don’t know at this time, he said.
But it is possible that otolaryngologists and ophthalmologists may find themselves working together a bit more in the future.
- Dhillon S, Shapiro CM, Flanagan J. Sleep-disordered breathing and effects on ocular health. Can J Ophthalmol 2007;42:238-43.
©2007 The Triological Society