Researchers aren’t sure if sleep apnea is associated with glaucoma in younger patients the way it is in middle aged and older patients; however, it is demonstrably associated with preclinical thinning in their peripapillary retinal nerve fiber layers (RNFL), according to new research. That’s at least suggestive that sleep apnea patients are at risk for glaucoma, even in young adulthood.

Investigators reviewed 848 cases of patients ages 19 to 22. Of the participants, 178 (21.0%) had obstructive sleep apnea (OSA) (150 with mild OSA, 26 with moderate OSA and two with severe OSA). They all were evaluated with optical coherence tomography imaging of the optic disc, intraocular pressure (IOP) measurements, axial lengths and refractive errors. They underwent overnight polysomnography studies, which obtained measurements of apnea-hypopnea index (AHI), peripheral oxygen saturation level and number of cortical arousals from sleep to determine the severity of their OSA. Participants who had any level of OSA had thinner average peripapillary RNFL at the inferotemporal and superotemporal segments than those without OSA. Additionally, the higher the AHI, the thinner the patient’s RNFL superotemporally. No significant differences were noted in optic disc measurements between groups of OSA severity.

The findings remained significant even after adjusting for sex, body mass index, ethnicity and potential ocular confounders.