Eye doctors can play a crucial role in identifying undiagnosed obstructive sleep apnea (OSA) in patients with retinal vein occlusion (RVO) by referring them for sleep studies. RVO, a significant cause of vision loss, is influenced by various vascular complications and shares multiple risk factors with OSA, including hypertension, diabetes, and smoking. These overlapping risk factors indicate a potential connection between the two conditions.
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Recent research published in *Retina* explored this link by comparing a group of RVO patients to those self-reporting a history of OSA. The study involved 321 RVO patients from a New Jersey retina clinic, divided into two cohorts: a retrospective group of 272 patients and a prospective group of 49 newly diagnosed patients who underwent polysomnography testing, either at home or in a lab. Notably, standard OSA screening questionnaires were excluded to assess all patients, not just those deemed high-risk for OSA.
Among the retrospective cohort, only 5.2% had previously been diagnosed with OSA. In contrast, four of the 49 patients in the prospective cohort reported severe sleep apnea. After excluding these individuals, the sleep tests revealed that 84.4% of the remaining patients had undiagnosed OSA. Including those with known severe sleep apnea, the rate of OSA identification rose to 85.7%, with over half of these patients showing moderate to severe cases (55%). The researchers emphasized the significant increase in diagnosed OSA cases through sleep testing compared to relying solely on previous medical history.
The study highlighted a 16-fold increase in the likelihood of an OSA diagnosis in the prospective group who underwent sleep testing compared to the retrospective cohort, suggesting a widespread underdiagnosis of OSA in the general population. The authors called for further research to explore the potential relationship between RVO and sleep apnea, recommending that clinicians consider sleep testing as part of the evaluation process for all RVO patients.