Patients undergoing clinical evaluation or treatment for obstructive sleep apnoea (OSA) should potentially be monitored for glaucoma, according to authors of a multicentre study comprising just over 12.5 million patients.1
The study drew on de-identified Electronic Health Record data from Epic Cosmos, spanning approximately 1,800 hospitals and health systems.
It found OSA is associated with a higher risk of incident glaucoma compared with sleep-tested controls. However, it was unable to establish whether the use of a positive airway pressure (PAP) device to manage OSA increases or decreases glaucoma risk relative to untreated OSA.
Adults were included in the study if they had an index encounter for OSA evaluation between 1 January 2010 and 31 October 2025, no prior glaucoma diagnosis, and at least 180 days of follow-up. They were categorised as sleep-tested controls without OSA (n=343,533), OSA without a PAP device record (n=12,162,550), or OSA with a PAP device record (n=10,524) within 180 days.
OSA is associated with a higher risk of incident glaucoma compared with sleep-tested controls.
The study aimed to measure incident glaucoma, defined as at least two glaucoma diagnosis codes within 365 days, with the first qualifying diagnosis occurring after the 180-day landmark.
Compared with sleep-tested controls, adjusted hazards of incident glaucoma were higher in OSA without a PAP device record (hazard ratio [HR], 1.27; 95% CI, 1.22-1.32) and OSA with a PAP device record (HR, 2.10; 95% CI, 1.80-2.45). At 10 years, cumulative incidence was 1.58%, 2.30%, and 3.86%, respectively.
Reference
- Nishida T, Mittal R, Moghimi S, et al. Positive airway pressure and long-term glaucoma risk in obstructive sleep apnea: A real-world cohort study. Ophthalmology Glaucoma, 2026. doi: 10.1016/j.ogla.2026.05.012.
