Those who have obstructive sleep apnea (OSA) are at an “elevated risk” of developing age-related macular degeneration and progressing to the later stages of the disease, according to a recent study in Ophthalmol Retina.1
Specifically, individuals diagnosed as having OSA five years after this diagnosis had a significantly elevated risk of nonexudative AMD (HR, 2.64, 95% CI, 2.37 – 2.96; P<.001), exudative AMD (HR, 2.48, 95% CI, 1.99 – 3.11; P=.002), and needed anti-VEGF therapy (HR, 2.85, 95% CI, 2.26 – 3.59; P<.001) vs. the control cohort.
What’s more, in a secondary assessment, those OSA individuals with non-advanced AMD had an elevated risk of geographic atrophy (GA; HR, 7.00, 95% CI, 4.47 – 11.0; P=.03), exudative AMD (HR, 2.87, 95% CI, 2.37 – 3.48; P=.03), and needed anti-VEGF injections (HR, 4.72, 95% CI, 3.59 – 6.22; P=.02) vs. those without OSA who were diagnosed with non-advanced AMD.
"In my opinion, this study suggests a potential link between sleep apnea and an increased risk of macular degeneration, which could influence clinical practice by encouraging clinicians to be more vigilant in monitoring patients who have sleep apnea for AMD," explains Mohammad Rafieetary, OD, FAAO, FORS, a member of the Optometric Retina Society. "For those patients who have been diagnosed with AMD, and who are not actively treated for nAMD or geographic atrophy, the frequency of follow-ups, or visit intervals, can be determined by considering the patient’s risk factors for disease progression. These include the stage of AMD, family history, genetic status, lifestyle, including smoking, and comorbidities. Based on this study, ODs can add OSA as one of these comorbidities."
The study was comprised of 58,700 individuals who either had OSA or did not, respectively. Data on these individuals were collected using a deidentified EHR research network. Secondary assessments were included to determine non-advanced AMD progression in those with and without diagnosed OSA at five years.
Dr. Rafieetary adds that optometrists are in a good position to recognize the signs of OSA to discuss the possibility with the patient and refer them for sleep studies or to their PCP. OM
1. Alshaikhsalama AM, Alsoudi AF, Wai KM, Koo E, Mruthyunjaya P, Rahimy E. Association between Obstructive Sleep Apnea and Age-related Macular Degeneration Development and Progression.Ophthalmol Retina. Published online December 9, 2024. doi:10.1016/j.oret.2024.12.004