The association between obstructive sleep apneahypopnea syndrome and glaucoma: a Meta analysis

Abstract

Background Studies have showed an increasing prevalence of glaucoma in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). However, this view remains controversial. Objective This Meta analysis was to assess whether there is an association between glaucoma and OSAHS. Methods A systematic search in PubMed database was carried out with the subject headingssleeping apneaandglaucoma. The literature type was limited to cases-controlled studies and prospective cohort studies with the publishing duration from January 1, 1982 to January 30, 2015 in English.The risk of glaucoma among OSAHS patients was analyzed, and Review Manager 5.2 was applicated for Meta analysis.The pooled odds ratio (OR) and 95% confidence interval (CI) was calculated to assess the strength of the association. Results Twelve independent retrospective cases-controlled studies were included in this review, including 11 592 subjects in the OSAHS group and 25 931 subjects in the control group.The study quality was scored 6-8 by Newcastle-Ottawa Scale which was acceptable.The random effects model was accepted because of the heterogeneity among the studies (χ2=34.20, P<0.05, I2=68%). The prevalence of glaucoma was higher in the OSAHS group than that in the control group (OR=1.87, 95%CI: 1.21-2.90, Z=2.82, P<0.05). The subgroup analysis of OSAHS showed that the OR (95% CI) of mild, moderate and severe OSAHS groups versus control group was 3.61 (0.56-23.43), 4.17 (0.47-36.91) and 6.95 (1.14-42.26), respectively.Sensitivity analysis confirmed that the OR value fluctuated in 1.74-2.16 and closed to 1.87.Funnel graphy exhibited a asymmetry appearance among the literatures, which suggested a possible publication bias. Conclusions OSAHS is one of the risk factors of glaucoma.The serious OSAHS is associated with an increased risk of glaucoma. Key words: Glaucoma/etiology; Sleep apnea, obstructive/complications; Comorbidity; Risk factors; Prevalence; Retrospective studies; Meta-analysis; Humans