Sleep Apnea Severity Associated With Retinal Nerve Fiber Layer Damage

obstructive sleep apnea, CPAP machine, sleep
Researchers say patients with moderate to severe obstructive sleep apnea have significantly thinner median average retinal nerve fiber layers than patients without it.

The following article is a part of conference coverage from the American Academy of Ophthalmology 2020, being held virtually from November 13 to 15, 2020. The team at Ophthalmology Advisor will be reporting on the latest news and research conducted by leading experts in ophthalmology. Check back for more from the AAO 2020.

Obstructive sleep apnea (OSA) severity may correlate with increased structural retinal nerve fiber layer (RNFL) damage, according to research results presented at the American Academy of Ophthalmology 2020 annual meeting, held virtually November 13 to 15, 2020. 

Investigators conducted a retrospective review of 131 adult patients at the New York Eye and Ear Infirmary of Mount Sinai in order to evaluate the relationship between OSA and RNFL. Participants had primary open-angle exfoliation, pigmentary or angle-closure glaucoma, glaucoma suspect, or ocular hypertension, and underwent OSA evaluation. Independent t tests and linear regression were used to analyze data. 

In total, 80% of participants had no or mild OSA; 20% had moderate to severe OSA. Patients with moderate to severe OSA had significantly thinner median average RNFL (57.77 ± 10.47 µm) compared with patients with no or mild OSA (65.37 ± 16.63 µm; P =.01). Researchers found a significant, weak negative correlation between Apnea-Hypopnea Index and RNFL (r = -0.19; P =.03) after controlling for gender, but not for age. 

“Average RNFL was significantly thinner in the [moderate to severe] OSA group compared to [none to mild],” the researchers concluded, “indicating increased structural retinal damage with greater OSA severity.” 

Visit Ophthalmology Advisor’s conference section for complete coverage of AAO 2020.



Gardin MA, Ritch R. The relationship between obstructive sleep apnea and RNFL thickness. Presented at: American Academy of Ophthalmology 2020 Annual Meeting; November 13-15, 2020. Abstract PO156.