LAUSR

Background Several ocular problems had been found in association with obstructive sleep apnea (OSA), including vision threatening and non-threatening disorders. Aim to identify the magnitude and predictors of vision-threatening and non-threatening ocular complications of OSA. Methods 80 patients above 30 years diagnosed with moderate to severe OSA at the sleep clinic of Mansoura University Hospital and 20 controls were assessed for the presence of ocular complications at Mansoura Ophthalmic Center. The OSA was diagnosed after full night polysomnographic study and its severity based on apnea hypopnea index. The ophthalmic examination includes, uncorrected visual acuity measurement, best-corrected visual acuity measurement, slit-lamp examination of the anterior segment and anterior segment photography, dilated fundus examination, intraocular pressure measurement, fundus photo and fluorescein angiography, and automated perimetry. Results OSA patients were observed to be at greater risk of conjunctival hyperemia and dry eye (OR=3.77, 4.36, respectively). Also, 28 (35%), 24 (30%) and 4 (5%) OSA patients had senile cataract, glaucoma, and retinal ischemia respectively with an overall prevalence of 45% and 7 times greater risk (OR=7.36) of vision threatening disorders. On multivariate logistic regression, the lowest oxygen saturation index was the only significant predicator negatively associated with vision-threatening disorders (OR=0.84). Conclusion the risk of vision non-threatening disorders (conjunctival hyperemia and dry eye) and vision-threatening disorders (cataract, glaucoma, and retinal ischemia) are higher among OSA cases. OSA treatment to keep optimal lowest oxygen saturation index together with eye follow up are recommended to protect vision.