Long-term effects of obstructive sleep apnea and its treatment on open-angle glaucoma: a big-data cohort study

Study Objectives: The relationship between open-angle glaucoma (OAG) and obstructive sleep apnea (OSA) is unclear. The long-term risk for OAG after OSA diagnosis has not been investigated. Therefore, we assessed the risk for OAG among patients with OSA over a 12-year follow-up period using nationwide, population-based data. Methods: The OSA group was randomly selected from among 3.5 million individuals registered with the National Health Insurance Service. The non-OSA group was obtained through propensity score matching considering several variables. The primary endpoint was glaucoma diagnosis. Results: The OSA and non-OSA groups both included 6,369 individuals. The overall hazard ratio for OAG in the OSA group was 1.42 (95% confidence interval [CI]: 1.19–1.69). In subgroup analysis, the hazard ratio for OAG was 1.94 (95% CI: 1.57–2.41) for those aged > 60 years, 1.50 (95% CI: 1.20–1.89) for those with diabetes mellitus, 1.53 (95% CI: 1.26–1.86) for those with hypertension, and 0.71 (95% CI: 0.52–0.96) for those with a history of OSA surgery. Conclusions: Over the 12-year follow-up, the risk for OAG increased after OSA diagnosis. Further research will be necessary to determine if treating OSA can mitigate this association.