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Wednesday / June 19.
HomeminewsCPAP May Slow NPDR

CPAP May Slow NPDR

Long-term continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnoea (OSA) and nonproliferative diabetic retinopathy (NPDR) may slow retinal disease progression. On the flip side, it may induce an increase in retinal microhaemorrhages.

Although OSA is known to be associated with impaired glycaemic control, and a higher risk of vascular complications, the effect of apnoea-hypopneas suppression on retinal disease progression is unclear.

A small open-label, parallel-group, randomised controlled trial, conducted between October 2016 and February 2020 at a University Hospital in Spain, explored the efficacy and safety of CPAP for the reduction of retinal lesions in patients with NPDR and OSA.1

It found that after 52 weeks of CPAP treatment there was an associated 21.7% reduction from baseline of eyes with hard exudates (P=0.035). Additionally optical coherence tomography (OCT) showed a reduction from baseline indices of retinal oedema, including central subfield thickness and cube volume.

The study authors reported that “in patients who met prespecified criteria for CPAP adherence, treatment was also associated with a higher number of retinal microhaemorrhages at 52 weeks (intergroup adjusted difference, 6.0 [95% confidence interval 0.6 to 11.5]; P=0.029), which was directly related to prescribed pressure levels. CPAP treatment also improved glycaemic control, sleepiness, and general healthrelated quality of life.”

Reference

  1. García-Sánchez, A., Asencio, M., GarcíaRío, F., et al., CPAP effect on progression of retinal disease in patients with sleep apnea and non-proliferative diabetic retinopathy: a randomized clinical trial. Ann Am Thorac Soc. 2023 Oct 4. DOI: 10.1513/AnnalsATS.202304- 296OC. Epub ahead of print. PMID: 37793101