Sleep Apnea Does Not Affect Visual Outcomes of Thyroid Eye Disease Treatment

Apnea treatment
mature man sleeping, using a mask for sleep disorder treatment (this picture has been taken with a Hasselblad H3D II 31 megapixels camera)
ASOPRS research shows visual outcomes of orbital decompression surgery are not worse for patients with OSA.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, held in New Orleans from November 11 to 12, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the oculoplastic researchers and other clinicians at the ASOPRS. Check back for more from the ASOPRS 2021 Fall Scientific Symposium.

Risk of obstructive sleep apnea (OSA) was not associated with visual outcomes in patients with thyroid eye disease (TED) who received orbital decompression treatment, researchers found in a report presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium in New Orleans, November 11-12.

TED symptoms become more severe in patients with TED and higher risk of OSA identified through STOP-BANG scores, previous research has indicated. However, research has not yet been conducted on whether OSA status is linked with orbital decompression outcomes in patients with TED.

The research took into account 57 patients (83 eyes, mean age 53.7±15.7 years, 41 women) with TED who underwent orbital decompression at a single tertiary care center between 2010 and 2020. They were divided based on STOP-BANG score by low-risk OSA (0 to 2, 72% of patients), intermediate-risk OSA (3 or 4, 14%), and high risk OSA (score greater than 5, 14%).

Before the operation (31 bilateral, 26 unilateral), visual acuities were 0.24±31 (20/34) for low-risk, 0.31±0.19 (20/40) for intermediate-risk, and 0.23±0.16 (20/33) for high-risk OSA patients (P =.71).

Best-corrected visual acuity (BCVA) was measured before the operation and at the following time points: less than 1 month, 1 to 3 months, 3 to 6 months, 6 to 9 months, and 9 to 12 months after the operation.

At the follow up of 9 to 12 months, the researchers discovered that visual acuities were 0.10±0.10 (20/25) for low-risk, 0.19±0.10 (20/30) for intermediate-risk, and 0.27±0.17 (20/37) for high-risk OSA patients (P =.08).

Visual outcomes in the 1st year following the operation were not linked with OSA status. The trend of patients with low risk of OSA having higher BCVA around 9 to 12 months postoperatively, compared with patients with intermediate or high risk of OSA was not statistically significant.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

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Gervasio KA, McKnight T, Xu V, et al. The effect of obstructive sleep apnea risk on visual outcomes in thyroid eye disease patients following orbital decompression. Poster presented at ASOPRS 52nd Annual Fall Scientific Symposium; November 11-12, 2021; New Orleans, LA.