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Is there an association between pre-existing sleep apnoea and the development of glaucoma?
  1. C A Girkin1,
  2. G McGwin, Jr2,
  3. S F McNeal1,
  4. C Owsley1
  1. 1Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
  2. 2Department of Epidemiology and International Health, School of Public Health, and Section of Trauma, Burns, and Surgical Critical Care, Division of General Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
  1. Correspondence to: Christopher Girkin UAB Department of Ophthalmology, 1800 University Blvd, EFH 609, Birmingham, AL 35294-0009, USA; cgirkin{at}


Aim: To determine if sleep apnoea is associated with an increased risk of developing glaucoma.

Methods: This was a nested case-control study. Patients seen at the Veterans Affairs Medical Center (BVAMC) in Birmingham, Alabama, with newly diagnosed glaucoma (cases) between 1997 through 2001 were selected (n = 667) and age matched with non-glaucomatous controls (n = 6667). Patient information was extracted from the BVAMC data files containing demographic, clinical, and medication information. An index date was assigned to the glaucoma subjects corresponding to the time of diagnosis. Patients who had a glaucoma diagnosis before the observation period of the study were excluded. 10 controls were randomly selected for each case and matched on age (plus or minus 1 year) and an encounter on or before the index date of the matched case. Ihe main outcome measures were crude and adjusted relative risks for the association between the previous diagnosis of sleep apnoea and the development glaucoma. Adjustment was performed for the associations of diabetes, lipid metabolism disorders, hypertension, cardiovascular disease, cerebrovascular disease, arterial disease, and migraines.

Results: Individuals who developed glaucoma were more likely to have a previous sleep apnoea diagnosis relative to control subjects. However, this finding was of borderline significance at an alpha of 0.05 (p value = 0.06, odds ratio = 2.20, 95% confidence intervals 0.967 to 5.004). Following adjustment for other potential risk factors, no significant difference was seen (p value = 0.18, odds ratio = 1.80, 95% confidence interval 0.76 to 4.23).

Conclusions: This nested case-control study does not support a large impact of sleep apnoea on the eventual development of glaucoma relative to other putative risk factors.

  • NTG, normal tension glaucoma
  • POAG, primary open angle glaucoma
  • open angle glaucoma
  • sleep apnoea
  • NTG, normal tension glaucoma
  • POAG, primary open angle glaucoma
  • open angle glaucoma
  • sleep apnoea

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  • Financial support: This research was supported by NIH grant K23 EY13959-01, NIH grant R21-EY14071, Research to Prevent Blindness, Inc, and the EyeSight Foundation of Alabama. Cynthia Owsley is a Research to Prevent Blindness Senior Scientific Investigator.

  • Proprietary interest statement: none.