Retinal Vein Occlusion Risk Increased With Obstructive Sleep Apnea

Risk for retinal vein occlusion (RVO) is higher among patients with obstructive sleep apnea (OSA), according to results of a retrospective cohort study published in Eye.

Researchers evaluated the relationship between RVO and OSA using data from the United States Collaborative Network of the TriNetX Platform. Patients who presented for ophthalmologic care were evaluated for RVO history and OSA status. A propensity score matching approach was used to balance for cohort differences.

Patients with (n=19,918) and without (n=3,279,582) a history of RVO were a mean (SD) age of 68.3 (14.5) and 50.2 (21.2) years, and 53.0% and 56.9% were women, and respectively. Risk for RVO was associated with OSA among Hispanic patients (risk ratio [RR], 1.77; 95% CI, 1.30-2.40), men (RR, 1.35; 95% CI, 1.19-1.52), White patients (RR, 1.32; 95% CI, 1.17-1.49), and women (RR, 1.28; 95% CI, 1.14-1.45).

When stratified by RVO type, branch RVO accounted for all significant associations. Branch RVO was associated with OSA among Hispanic patients (RR, 1.87; 95% CI, 1.25-2.78) men (RR, 1.47; 95% CI, 1.26-1.72), White patients (RR, 1.42; 95% CI, 1.22-1.65), Black patients (RR, 1.39; 95% CI, 1.11-1.74), and women (RR, 1.38; 95% CI, 1.19-1.60). The researchers found no significant association between central RVO and OSA among any sociodemographic subgroups.

Further, patients with OSA were more likely to progress to macular edema (RR, 3.70; 95% CI, 3.17-4.31), vitreous hemorrhage (RR, 2.29; 95% CI, 1.64-3.20), neovascularization (RR, 2.22; 95% CI, 1.69-2.91), and photocoagulation (RR, 1.73; 95% CI, 1.29-2.33).

Study limitations include potentially confounding variability in OSA severity and an underrepresentation of Asian patients.

The study authors concluded, “OSA may be a risk factor for RVO in both males and females, and both [White] and [Hispanic] populations. This finding was particularly pronounced in [Hispanic] individuals, highlighting the need for future studies on RVO and for vision care providers to give special attention to patients with OSA in this population.”

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